This article can give you a general idea about each of the medicines listed below. Only the most general side effects are listed. Ask your doctor if you need to take any special precautions. Use medicine as recommended by your doctor. If you have questions about use or side effects, contact your doctor.
Many people with CFS may be sensitive to medicines. For this reason, the doctor may begin with very low doses. If needed, the dose can be slowly increased.
CFS is complex. The doctor may advise different types of medicine. They are used only to help with symptoms of CFS. Medicine is also used to treat other health problems such as anxiety, depression, pain, and sleep problems. They also have more than one use. For example, antidepressants may be helpful for those who have problems sleeping.
Prescription Medications
Over-the-Counter Medications
Prescription Medications
Common names:
- Modafinil
- Armodafinil
- Methylphenidate
- Dexamphetamine
- Amphetamine salts
Stimulants may help with symptoms of fatigue, brain fog, and memory problems. They are helpful for those who are sleepy during the day. The doctor will monitor use of these drugs.
Some problems are:
Different medicines are used for sleep problems. These include:
Common names:
- Amitriptyline
- Doxepin
- Nortriptyline
- Trazodone
- Mirtazapine
Antidepressants in low doses have a calming effect. They may be helpful for depression or if other treatments have not helped. It can take up to 6 weeks for these to fully work. Do not stop taking these drugs on your own. The dose has to be lowered over time.
Some problems are:
- Seizures
- Higher blood pressure
- Faster heart rate
- Dry mouth
- Mild tremor
- Problems passing urine (pee)
- Lightheadedness
- Painful or inappropriate erections (trazodone)
Cyclobenzaprine may help with muscle spasms or pain. Do not stop taking this drug on your own. The dose has to be lowered over time.
Some problems are:
- Sleepiness
- Lightheadedness
- Problems passing urine
- Tolerance and dependency
- Swelling in the legs
- Short-term memory problems
Common names:
- Gabapentin
- Pregabalin
These drugs may help calm restless legs or pain at night. Do not stop taking these drugs on your own. The dose has to be lowered over time.
Some problems are:
- Sleepiness
- Lightheadedness
- Weight gain
- Clumsiness
- Tolerance and dependency
- Increased risk of suicidal thoughts or behavior
Clonazepam is used to ease anxiety and promote sleep. For people with CFS, it can also help with restless legs and muscle spasms. Do not stop taking this drug on your own. The dose has to be lowered over time.
Some problems are:
- Drowsiness
- Lightheadedness
- Lack of coordination
- Slow reaction time
- Tolerance and dependency
Zolpidem will helps a person fall asleep faster. It can also help them stay asleep longer depending on the dose. Do not stop taking this drug on your own. The dose has to be lowered over time.
Some problems are:
- Return of insomnia symptoms
- Drowsiness
- Nausea
- Headache
- Diarrhea
- Tolerance and dependency
Zopiclone is used insomnia, but not for long periods of time. It helps a person fall asleep faster and stay asleep longer. Do not stop taking this drug on your own. The dose has to be lowered over time.
Some problems are:
- Return of insomnia symptoms
- Sleepiness
- Nausea or vomiting
- Lightheadedness
- Dry mouth
- Headache
- Lack of coordination
- Slow reaction time
- Tolerance and dependency
Promethazine can be used as a sleep aid. It can also ease nausea or restlessness. In some countries outside of the US, it is available without a prescription.
Some problems are:
- Problems thinking clearly (in the elderly)
- Sleepiness
- Hives
- Rash
- Lightheadedness
- Dry mouth
- Nausea or vomiting
Pain with CFS can be hard to treat. Over-the-counter medicines are used first. If they do not work for the doctor may prescribe medicines. Antidepressants are the most common.
The doctor may prescribe an opioid, but this is rarely done. Opioids must be used with care because of their side effects. The doctor will monitor those who use these medicines. They are highly addictive. Do not stop taking these drugs on your own. The dose has to be lowered over time.
Opioids for CFS include:
- Oxycodone
- Hydrocodone
- Morphine
- Fentanyl
- Buprenorphine
- Tapendatol
- Tramadol
Some problems are:
- Sleepiness
- Lightheadedness
- Nausea or vomiting
- Constipation
- Lack of coordination
- Slow reaction time
Over-the-Counter Medications
Acetaminophen
- Tylenol
Acetaminophen can ease pain from headache, or joint or muscle pain. It is important to follow the directions and not use too much.
Some problems are:
- Rash
- Nausea
- Vomiting
- Headaches with overuse
- Acetaminophen poisoning
- Toxic hepatitis
Common names:
- Naproxen
- Ibuprofen
NSAIDs may be used to ease pain and fever. They are generally safe when taken as advised.
Some problems are:
- Belly pain
- Gastrointestinal bleeding
- Nausea, heartburn, or vomiting
- Poor kidney function or injury
- Higher blood pressure
Special Considerations
When taking medicines:
- Take your medicine as advised. Do not change the amount or schedule.
- Be aware of the side effects of your medicine. Tell your doctor if you have any.
- Talk to your doctor before you stop taking any prescription medicine.
- Do not share your prescription medicine.
- Medicines can be harmful when mixed. Talk to your doctor or pharmacist if you are taking more than one. This includes over the counter products and supplements.
- Plan for refills.
References
Chronic fatigue syndrome. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/chronic-fatigue-syndrome. Accessed April 13, 2022.
Chronic fatigue syndrome. Merck Manual Professional Version website. Available at: https://www.merckmanuals.com/professional/special-subjects/chronic-fatigue-syndrome/chronic-fatigue-syndrome. Accessed April 13, 2022.
Noor N, Urits I, et al. A comprehensive update of the current understanding of chronic fatigue syndrome. Anesth Pain Med. 2021;11(3):e113629.
Richman S, Morris MC, et al. Pharmaceutical interventions in chronic fatigue syndrome: a literature-based commentary. Clin Ther. 2019;41(5):798-805.
Treatment of ME/CFS. Centers for Disease Control and Prevention website. Available at: https://www.cdc.gov/me-cfs/treatment/index.html. Accessed April 13, 2022.
Revision Information
- Reviewer: EBSCO Medical Review Board Marcin Chwistek, MD
- Update Date: 04/13/2022