{{YIELDBOT INTENT TAGS}} {{RUBICON REAL TIME}}
Medications for Chronic Fatigue Syndrome (CFS)

The information provided here is meant to give you a general idea about each of the medications listed below. Only the most general side effects are included, so ask your healthcare provider if you need to take any special precautions. Use each of these medications only as recommended by your healthcare provider, and according to the instructions provided. If you have further questions about usage or side effects, contact your healthcare provider.

Many people with CFS appear particularly sensitive to drugs, especially those that affect the central nervous system. For this reason, your healthcare provider may begin with very low doses and increase the dosage gradually as necessary.

The complex symptoms in CFS necessitate the use of different types of medication including those for anxiety and depression, pain control, and sleep disturbance.

Prescription Medications

Tricyclic antidepressants

  • Doxepin (Sinequan)
  • Amitriptyline (Elavil, Etrafon, Limbitrol, Triavil)
  • Desipramine (Norpramin)
  • Nortriptyline (Pamelor)
  • Imipramine (Tofranil)

Selective serotonin reuptake inhibitors (SSRIs)

  • Citalopram (Celexa)
  • Fluvoxamine (Luvox)
  • Paroxetine (Paxil)
  • Fluoxetine (Prozac)
  • Sertraline (Zoloft)

Please note: In March, 2004, the Food and Drug Administration (FDA) issued a Public Health Advisory that cautions physicians, patients, families, and caregivers of patients with depression to closely monitor both adults and children receiving certain antidepressant medications. The FDA is concerned about the possibility of worsening depression and/or the emergence of suicidal thoughts, especially among children and adolescents at the beginning of treatment, or when there’s an increase or decrease in the dose. The medications of concern—mostly SSRIs (Selective Serotonin Re-uptake Inhibitors)—are: Prozac (fluoxetine), Zoloft (sertraline), Paxil (paroxetine), Luvox (fluvoxamine), Celexa (citalopram), Lexapro (escitalopram), Wellbutrin (bupropion), Effexor (venlafaxine), Serzone (nefazodone), and Remeron (mirtazapine). Of these, only Prozac (fluoxetine) is approved for use in children and adolescents for the treatment of major depressive disorder. Prozac (fluoxetine), Zoloft (sertraline), and Luvox (fluvoxamine) are approved for use in children and adolescents for the treatment of obsessive compulsive disorder. For more information, please visit http://www.fda.gov/cder/drug/antidepressants .

Atypical antidepressants

  • Trazodone (Desyrel)
  • Venlafaxine (Effexor)
  • Bupropion (Wellbutrin)

Benzodiazepines

  • Lorazepam (Ativan)
  • Flurazepam (Dalmane)
  • Clonazepam (Klonopin)
  • Triazolam (Halcion)
  • Chlordiazepoxide (Librium)
  • Temazepam (Restoril)
  • Oxazepam (Serax)
  • Clorazepate (Tranxene)
  • Diazepam (Valium)
  • Alprazolam (Xanax)

Over-the-Counter Medications

Acetaminophen

  • Acetaminophen (Tylenol)

Nonsteroidal anti-inflammatory drugs (NSAIDs)

  • Naproxen (Aleve, Anaprox, Naprosyn)
  • Ibuprofen (Advil, Bayer Select, Motrin, Nuprin)

Prescription Medications

Tricyclic Antidepressants

Common names include:

  • Doxepin (Sinequan)
  • Amitriptyline (Elavil, Etrafon, Limbitrol, Triavil)
  • Desipramine (Norpramin)
  • Nortriptyline (Pamelor)
  • Imipramine (Tofranil)

Your healthcare provider may prescribe low-dose tricyclic agents to help improve your sleep and relieve mild, generalized pain. Improvement is usually seen in two to six weeks after beginning treatment.

Possible side effects include:

  • Dizziness
  • Dry mouth
  • Blurred vision
  • Constipation
  • Difficulty urinating
  • Weight gain
  • Low blood pressure
  • Sexual dysfunction
  • Rapid heart rate

Selective Serotonin Reuptake Inhibitors (SSRIs)

*** see note above

Common names include:

  • Citalopram (Celexa)
  • Fluvoxamine (Luvox)
  • Paroxetine (Paxil)
  • Fluoxetine (Prozac)
  • Sertraline (Zoloft)

Selective Serotonin Reuptake Inhibitors (SSRIs) are used to treat the depression that may accompany CFS, but they may also be beneficial for CFS even if you are not depressed. Improvement may be seen in four to six weeks after beginning treatment.

Possible side effects include:

  • Nausea
  • Diarrhea
  • Insomnia
  • Sexual dysfunction
  • Headache

Atypical Antidepressants

Common names include:

  • Trazodone (Desyrel)
  • Venlafaxine (Effexor)
  • Bupropion (Wellbutrin)

Atypical antidepressants are used to treat depression that may accompany CFS. Improvement is usually seen in four to six weeks after beginning treatment.

Possible side effects include:

  • Nausea
  • Nervousness
  • Diminished sex drive

Benzodiazepines

Common names include:

  • Lorazepam (Ativan)
  • Flurazepam (Dalmane)
  • Clonazepam (Klonopin)
  • Triazolam (Halcion)
  • Chlordiazepoxide (Librium)
  • Temazepam (Restoril)
  • Oxazepam (Serax)
  • Clorazepate (Tranxene)
  • Diazepam (Valium)
  • Alprazolam (Xanax)

Benzodiazepines are used to reduce anxiety and panic that may accompany CFS. They may also be used to promote sleep. Benzodiazepines are fast acting but can be habit-forming when used long-term or in excess. In such cases, withdrawal must be accomplished slowly, over a period of weeks or months.

Possible side effects include:

  • Drowsiness
  • Dizziness
  • Incoordination
  • Slow reaction time or impaired driving

Over-the-Counter Medications

Acetaminophen

  • Common name: Tylenol

Acetaminophen may be used to relieve pain from headache, joint pains, or muscle pain. To avoid stomach upset, this medication should be taken with food. Acetaminophen is generally safe when taken as recommended.

Possible side effects include:

  • Rashes
  • Acute liver or kideney failure
  • Nausea
  • Vomiting

Nonsteroidal Anti-inflammatory Drugs (NSAIDs)

Common names include:

  • Naproxen (Aleve, Anaprox, Naprosyn)
  • Ibuprofen (Advil, Bayer Select, Motrin, Nuprin)

Nonsteroidal anti-inflammatory drugs (NSAIDs) may be used to relieve pain and fever associated with CFS. These medicines should be taken with food to prevent stomach upset. They are generally safe when taken as recommended.

Possible side effects include:

  • Abdominal pain
  • Gastrointestinal bleeding
  • Nausea, heartburn, or vomiting

Special Considerations

Whenever you are taking a prescription medication, take the following precautions:

  • Take them as directed—not more, not less, not at a different time.
  • Do not stop taking them without consulting your healthcare provider.
  • Don’t share them with anyone else.
  • Know what effects and side effects to expect, and report them to your healthcare provider.
  • If you are taking more than one drug, even if it is over-the-counter, be sure to check with a physician or pharmacist about drug interactions.
  • Plan ahead for refills so you don’t run out.

When to Contact Your healthcare Provider

Contact your healthcare provider if you have any questions about your medication, any side effects that are troublesome, or if you feel that the medication is not working after the allotted time period.

References:

Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/.

Craig T, Kakumanu S. Chronic fatigue syndrome: evaluation and treatment. Am Fam Physician. 2002;65:1083-1090.

Devanur LD, Kerr JR. Chronic fatigue syndrome. J Clin Virol. 2006;37:139-150.

National Institute of Allergy and Infectious Diseases website. Available at: http://www3.niaid.nih.gov/.

Prins JB, van der Meer JW, Bleijenberg G. Chronic fatigue syndrome. Lancet. 2006;367:346-355.



Last reviewed April 2007 by David Juan, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.


Your Health and Happiness


DiggDeliciousNewsvineRedditStumbleTechnoratiFacebook