Medications and Stimulants for Chronic Fatigue Syndrome (ME/CFS)

Could drugs meant for hyperactive children be an effective treatment for adults with chronic fatigue syndrome (ME/CFS) adults? As illogical as it sounds, they might be.

This article looks at how and why stimulants for ADHD work for people with ME/CFS and what other treatments may help with this hard-to-treat disease.

What Is Chronic Fatigue Syndrome?

Chronic fatigue syndrome is a medical condition that causes severe fatigue, sleep problems, and difficulty concentrating. It is also called myalgic encephalomyelitis (ME/CFS). There is no known cause and the condition is long-term.

If you have ME/CFS, your symptoms may sometimes be so severe that you are unable to get out of bed. At other times, you may feel fine.  

ME/CFS is most common in people between the ages of 40 and 60. There is no cure for the condition, but treatment can help you manage your symptoms.

After ruling out other potential medical conditions, your healthcare provider can diagnose chronic fatigue syndrome based on your symptoms and medical history. 

Prescription Stimulants for ME/CFS

Some healthcare providers prescribe attention deficit disorder/attention deficit hyperactivity disorder (ADD/ADHD) drugs for their patients with ME/CFS and say they've seen positive results. There is a growing body of evidence to back this up, although more research is needed.

These drugs are classified as neurostimulators, which means that they stimulate brain activity. They're used for ADD/ADHD because, paradoxically, they have a calming effect on ADD/ADHD brains. Given that, it makes more sense that they'd be helpful in a condition defined by fatigue.

The most popular stimulants prescribed for chronic fatigue syndrome include:

• Ritalin and Concerta, which contain methylphenidate
• Dexedrine, which contains dextroamphetamine
• Adderall, which contains amphetamine and dextroamphetamine
• Vyvanse, which contains lisdexamfetamine

Why Use Neurostimulants?

The exact mechanism of these drugs isn't known (which is actually quite common in drugs that affect the brain), but they're believed to change the availability of two neurotransmitters—norepinephrine and dopamine—that are thought to be dysregulated in both ADD/ADHD and ME/CFS.

Low norepinephrine is linked to loss of alertness and memory problems, while dopamine deficiency is linked to cognitive impairment and inability to focus attention. These are symptoms that these two conditions have in common.

Researchers have demonstrated that, in adults, the two conditions share a lot of common symptoms including unexplained fatigue, functional impairment, and anxiety.

In a 2016 study, the long-term impact of taking methylphenidate for ME/CFS demonstrated a significant improvement in about one-third of the participants.

A study published in 2015 found dextroamphetamine was beneficial in a variety of conditions that are more common in women than in men, including ME/CFS, fibromyalgia, pelvic pain, and interstitial cystitis. Although dextroamphetamine has been proven an effective treatment for ME/CFS in the past, the research is limited.

A 2013 study suggested that lisdexamfetamine was significantly more effective than placebo when it came to improving executive brain function in ME/CFS. Executive brain function is a set of mental skills that help you get things done, and it's often compromised in this condition. The drug also improved participants' pain, fatigue, and global function.

Other Medications for ME/CFS

There is no standard approved treatment for ME/CFS. Some people find that lifestyle changes and stress management are helpful. Besides stimulant medications, your healthcare provider may recommend certain over-the-counter (OTC) remedies or other types of prescription medication. 

Over-the-Counter Medications

Pain can be treated with topical pain relief creams like: 

• Aspercreme (trolamine salicylate)
• Capzasin (capsaicin)
• Tiger Balm (camphor and menthol)
• Salonpas patches (camphor, menthol, and methyl salicylate)
  

NSAID pain relievers like Advil (ibuprofen) or Aleve (naproxen) may also be helpful.

Sleep Aids

OTC sleep remedies can help you get a good night's rest. They are usually recommended for short-term use. These include:

• Nytol (diphenhydramine)
• Unisom (doxylamine)
• Melatonin

If OTC remedies don't work for you, your healthcare provider may prescribe low dose sleep medication such as:

• Ambien (zolpidem)
• Klonopin (clonazepam)
• Lunesta (eszopiclone)
• Rozerem (ramelteon)
• Sonata (zaleplon)

Some common side effects of prescription sleep medication include:

• Daytime drowsiness
• Dry mouth
• Nausea and diarrhea
• Change in appetite
• Brain fog

Because long-term use of prescription sleep medication may lead to dependence, these drugs are recommended for short-term use.

Anti-Depressants

Antidepressants can be helpful for some people with ME/CFS. Your healthcare provider may prescribe a selective serotonin reuptake inhibitor (SSRI) or a serotonin-norepinephrine reuptake inhibitor (SNRI). Serotonin plays an important role in the sleep-wake cycle. Norepinephrine can help with stress. Some of the medications your healthcare provider might consider include:

• Cymbalta (duloxetine)
• Effexor (venlafaxine)
• Paxil (paroxetine)
• Prozac (fluoxetine)
• Zoloft (sertraline)

These drugs can have side effects such as:

• Nausea
• Dry mouth
• Insomnia
• Loss of appetite
• Sexual problems such as reduced sexual desire
• Headache
• Dizziness
  

Some people also report increased thoughts of suicide. Be sure to discuss these potential side effects with your healthcare provider before taking any of these medications.

A Word From Verywell

These medications are already on the market and are relatively inexpensive, which makes it easy for people to obtain. A drawback is that they carry a risk of addiction, so if you take them, you may have to see your healthcare provider more frequently.

If you're interested in trying these drugs, talk to your healthcare provider. Keep in mind that some healthcare providers may not be willing to prescribe these drugs off-label for ME/CFS based only the evidence we have so far. Be sure to talk about your full range of symptoms, other conditions you may have, and what drugs and supplements you're currently taking.

Remember that no single medication works for everyone with ME/CFS and that it's unlikely to improve all of your symptoms.