Treating Chronic Fatigue
Syndrome (ME/CFS) and Fibromyalgia: "A Prescription For Sleep"
Alternative medications may be the first choice for chronic fatigue syndrome
(ME/CFS) patients
but they are often not effective enough. A panel of prominent ME/CFS doctors indicated that while they were open to the use of over the counter products like
melatonin, Benadryl and Tylenol PM that they don’t usually provide enough
relief. Prescription drugs may have some side
effects but most doctors seem to regard the tradeoff as acceptable.
As with any treatment there will be a broad spectrum of responses. Dr.
Bateman says "Every drug has this spectrum of how it will work; every drug on
here has proven value, proven safety, yet it could be horrible for any one
person....Topamax (for instance)
is really hard for some people, but for others, it’s incredible, so you can’t
generalize about a drug."
Several physicians reported their patients often need two types of sleep
drugs, one to put them to sleep and one to keep them asleep. Dr. Teitelbaum goes
further arguing that getting a solid eight to ten hours of restful sleep is
worth taking the time and effort to settle on as many as five or six different
sleep aids if necessary. Since most of the side effects (and fewer of the
benefits) come at higher doses, he believes patients can maximize their benefits
by taking small amounts of several sleep aids at once.
"Many people....are afraid to take enough medication to get adequate
sleep. They are so grateful to get five hours of sleep a night that they
settle for that. That's a bad idea. I recommend taking whatever is necessary
to get eight to nine hours of solid sleep..even if it means taking several
of these medications at one time".
Prescription Drugs:
These drugs have shown promise in assisting sleep in
chronic fatigue syndrome (ME/CFS). See the chart below for more recommendations
from ME/CFS physicians.
Prescription Drug Chart
The chart below provides recommendations from nine prominent ME/CFS
physicians. While their recommendations vary they display a general
consistency that is encouraging.
ME/CFS Physician Recommendations for Prescription Sleep Medications
|
ME/CFS Physician
|
Sleep Initiators
|
Sleep Prolongers
|
|
Dr. Bateman
|
Ambien, Sonata, Lunesta, Restoril, Melatonin, Rozarem, Zyprexa
|
Trazodone, Remeron, Neurontin, Lyrica, Amytriptyline
|
|
Dr. Bell
|
Flexeril, Carisoprodol, Elavil, Klonopin, Ambien, Sonata
|
Trazodone
|
|
Dr. Klimas
|
Sinequan (Doxepin) elixir, Elavil, Flexeril, Klonopin
|
|
|
Dr. Lapp
|
Clonzepam, Sonata, Lunesta, Ambien, Klonopin
|
Trazodone
|
|
Dr. Levine
|
Sinequam (Doxepin), Klonopin
|
Trazodone, Amytriptyline, Norpramin, Neurontin, Cyclobezaprine
|
|
Dr. Pocinki
|
Ambien/Ambien CR
|
Amitryptyine, Trazodone
|
|
Dr. Rosenbaum
|
Elavil, Sinequan (Doxepin) elixir, Sonata
|
|
|
Dr. Teitelbaum
|
Ambien, Klonopin, Sinequam,
Flexeril, Zanaflex |
Trazodone, Neurontin, Sonata,
Amitryptyline |
|
Dr. Wallace
|
Ambien, Klonopin
|
Neurontin
|
Sleep Intro /
Good Sleep Hygiene /
Sleep Alternative Therapies
The Phoenix Rising
website is compiled by a layman. It is not a substitute for a physician and is
for informational uses only. Please discuss any treatments in these pages with
your physician.
______________________________________
Lucinda
Bateman, MD., 2006. “
Tips and Travails of Treatment”, An abridged version of
a seminar transcript of a Nov. Lecture in Auckland, New
Zealand by Pat Fero and David Thompson.
David S. Bell, M.D.,
02-13-2002, “Medications
for Chronic Fatigue Syndrome and Chronic Pain Control”,
ImmuneSupport.com.
http://www.immunesupport.com/library/showarticle.cfm/ID/3343
Charles Lapp, MD., 1999. “The
Treatment of Chronic Fatigue Syndrome and Fibromyalgia”.
ImmuneSupport.com,
07-03-2006.
http://www.immunesupport.com/library/showarticle.cfm/ID/2926
Carol Sieverling. 2000.
Paul Cheney, M.D on
Klonopin – Protecting Your Brain. by Carol Sieverling from the CFIDS and
FMS Support Group of
Dallas
Fort Worth.
Jacob Teitelbaum, 2007. From Fatigued to Fantastic, Avery Publishers.