Question: Have there been any new ways of successfully treating chronic fatigue syndrome (CFS)?

Dr. Hibberd's Answer:

Chronic fatigue syndrome (CFS) has a constellation of accompanying symptoms in most patients, and there is no specific treatment. Because may medications are used for off-label purposes, your insurance may not cover them because they lack FDA approval for CFS.

Much of the time, there are alternative diagnoses that can be provided to facilitate insurance coverage, but only for FDA-approved medications within their approved usage from FDA guidelines.

Drugs commonly used for CFS symptom relief are:

1) Antidepressants. These include low doses of Elavil, Pamelor, or doxepin, and selective serotonin reuptake inhibitors (SSRIs) such as Prozac, Paxil, or Zoloft.
2) Pain medications (NSAID's, Tylenol, etc.).
3) Antianxiety agents (Xanax, Ativan, Clonopin, etc.).
4) Antihistamines (Zyrtec, etc. for allergy symptoms).

We usually avoid stimulant medications, since their use tends to complicate instead of helping chronic fatigue. Selective sleep agents may be indicated for periodic use also. Even though more aggressive and experimental therapies are proposed now and again, there are no new discoveries.

The mainstay of treatment of CFS centers around discovering an underlying precipitant for the CFS. If not evident, continued monitoring and psychological support is best together with moderating daily activity. A sensible diet with regular daily exercise and judicious use of selected medications and appropriate supplementation when deficiencies are recognized are useful in providing quality of life to those who need help.