Medications

• Nonsteroidal anti-inflammatory drugs: People use these medications, also called NSAIDs, for pain relief. Some are available without a prescription, including naproxen (Aleve) and ibuprofen (Advil, Bayer Select, Motrin, Nuprin). Prescription drugs include tramadol hydrochloride (Ultram), celecoxib (Celebrex), and other naproxen-containing medications (Anaprox, Naprosyn).



• Low-dose tricyclic antidepressants: These medications may improve sleep and relieve mild generalized pain. Examples include doxepin (Adapin, Sinequan), amitriptyline (Elavil, Etrafon, Limbitrol, Triavil), desipramine (Norpramin), and nortriptyline (Pamelor).



• Other antidepressants: Newer antidepressants have been used to treat depression in people with chronic fatigue syndrome. These antidepressants include fluoxetine (Prozac), sertraline (Zoloft), paroxetine (Paxil), venlafaxine (Effexor), trazodone (Desyrel), and bupropion (Wellbutrin).



• Anxiolytic agents: These medications are used to treat anxiety in people with CFS. Examples include alprazolam (Xanax) and lorazepam (Ativan).



• 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 CFS 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 CFS 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 CFS itself.

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