What medications cure chronic fatigue syndrome?

Tricyclic Antidepressants. Antidepressants known as tricyclics may be particularly helpful for chronic fatigue syndrome patients. For example, the tricyclic amitriptyline (Elavil) is known to relieve many of the symptoms of chronic fatigue syndrome, including sleeplessness and low energy levels. They may provide benefits by promoting deep sleep and inhibiting pain pathways in the nervous system. Improvement in symptoms can take three to four weeks. Other tricyclics include doxepin (Sinequan), desipramine (Norpramin), nortriptyline (Pamelor), clomipramine (Anafranil), and imipramine (Tofranil, Janimine). These agents can have severe side effects, although patients with chronic fatigue syndrome normally respond to much lower doses than those used to treat people with depression. In fact, many chronic fatigue syndrome patients cannot tolerate the higher doses commonly used to treat the psychiatric disorder. Like all medications, tricyclics must be taken as directed; overdose can be life threatening.

Monoamine Oxidase Inhibitors (MAOIs). Monoamine oxidase inhibitors (MAOIs) block the enzyme monoamine oxidase, which has negative effects on many of the neurotransmitters that are important for well being. In one study moclobemide, a newer MAOI, was associated with improved energy levels in chronic fatigue syndrome patients regardless of whether they are depressed or not. Other MAOIs are likely to have similar effects. The most serious side effect of MAOIs is severe hypertension, which can be brought on by eating certain foods having a high tyramine content. Such foods include aged cheeses, most red wines, sauerkraut, vermouth, chicken livers, dried meats and fish, canned figs, fava beans, and concentrated yeast products. They also have serious interactions with a number of medications and should not be taken by pregnant women.

Stimulants: Stimulants may be used to treat lethargy or daytime sleepiness. Studies using modafinil (Provigil) have been completed, but the results have not been published, and currently this drug is only indicated for narcolepsy (brief attacks of deep sleep) and excess daytime sleepiness in patients identified in proper sleep studies.

Antimicrobials: A specific infection as a cause for chronic fatigue syndrome has not been identified, and antibiotic, antiviral, and antifungal drugs should not be prescribed for treatment of chronic fatigue syndrome in general. However, in people with elevated C pneumoniae levels, particularly increased IgM titers, antibiotic therapy with doxycycline (Doryx, Doxy) may be effective.

Anti-allergy therapy: Some people with chronic fatigue syndrome have allergies that periodically flare up. Nonsedating antihistamines may be helpful and include desloratadine (Clarinex), fexofenadine (Allegra), and cetirizine (Zyrtec). However, allergy therapy does not treat chronic fatigue syndrome itself.

Nicotinamide-Adenine Dinucleotide (NADH): A natural vitamin-like antioxidant supplement called nicotinamide adenine dinucleotide, or NADH (Enada), is also in trials. This substance boosts the brain chemical serotonin and triggers adenosine triphosphate (ATP), an energy-producing molecule found in every cell. Small studies are reporting improved symptoms in patients taking it, even after 18 months. Although the studies are small, these results showed promise.

More information on chronic fatigue syndrome (CFS)