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Chronic Fatigue Syndrome (cont.)

Medical Treatment

Patient Comments

Medical therapy is designed to relieve the specific symptoms of chronic fatigue syndrome. People with CFS are often sensitive to many medications, especially those that affect the central nervous system. Usually, your doctor will begin with low doses of medication and gradually increase the dose depending on side effects and your response to the medication. Because drug therapy is directed at symptom relief, medications should only be used in CFS if all other causes of the symptom have been ruled out. Remember that all medications can cause side effects. Talk to your doctor before beginning any new medication and if any side effect develops.

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.

Always ask your doctor about any new treatment, including herbal supplements.

Medically Reviewed by a Doctor on 8/31/2015

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Chronic Fatigue Syndrome - Coping With the Symptoms

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Read What Your Physician is Reading on Medscape

Chronic Fatigue Syndrome »

Chronic fatigue syndrome (CFS) is a disorder of unknown etiology that probably has an infectious basis.

Read More on Medscape Reference »

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