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Chronic Fatigue Syndrome quick look
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This chart rates treatment options according to general effectiveness, ease of use,
side effects and safety.
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Graded exercise
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Very good
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One of the most effective forms of treatment for chronic fatigue syndrome. Time-consuming.
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Graded exercise
A graded exercise program (with or without a formal exercise education program) is one of only two treatments that has been shown to help in several studies. With graded exercise the frequency, duration, or intensity of exercise is gradually increased over time. The exact type of exercise/activity is not important.
The only downside to this type of program is that it is difficult to build endurance so that 30 minutes of exercise, five times a week, can eventually be achieved. Reaching this level of fitness takes time and a big commitment from people with chronic fatigue syndrome.
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Cognitive behavioral therapy
(Group therapy)
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Very good
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Effective. A type of "talking therapy" which teaches practical behaviors including social skills, self-control, and practical problem solving. One of only two forms of treatment shown to be effective for chronic fatigue syndrome.
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Cognitive behavioral therapy
Studies that evaluated the effectiveness of group therapy using a cognitive behavioral therapy approach found improvements in symptoms and in physical activity. Therapy sessions were held weekly or every other week for 6 to 16 meetings in total. A few studies combined group therapy with relaxation therapy.
The benefits of cognitive behavioral therapy were not as clear as for graded exercise, but there was no harm from the treatment. As with graded exercise, this type of treatment requires a big commitment on the part of the person with CFS.
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Dietary supplements
(Magnesium, essential fatty acids, liver extracts)
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Poor
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Weak evidence that magnesium and essential fatty acids may improve symptoms. Liver extract is not recommended.
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Dietary supplements
The evidence for magnesium or essential fatty acids are weak but neither treatment is likely to be harmful.
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Razadyne/galantamine
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Very poor
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Not recommended. Not effective. Many side effects.
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Razadyne/galantamine
Galantamine is a drug used for treating Alzheimer's disease and there was hope that it would also work in chronic fatigue syndrome. However, a very good large study found no benefit.
Almost 30% of patients in this study stopped taking the drug because of side effects.
While the drug did not work, it is the sort of well-planned study that is needed for chronic fatigue. Most of the other studies arenot as well-designed.
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Immune therapies
(Gammagard/immune globulin, Intron/interferon)
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Very poor
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Not recommended. Not effective. Many side effects.
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Immune therapies
Studies of this type of treatment have been disappointing. Side effects were greater than any help from the treatment.
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Steroids
(Hydrocortisone, fludrocortisone, more)
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Very poor
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Not recommended. Not effective. Many side effects.
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Steroids
Studies of this type of treatment have not shown value in the treatment of chronic fatigue syndrome.
These drugs are powerful and can cause a number of side effects.
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Antiviral drugs
(Zovirax/acyclovir)
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Very poor
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Not recommended. Not effective.
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Antiviral drugs
One study of acyclovir showed no benefit for the treatment of chronic fatigue. This study was done at a time when a chronic infection was suspected to be the cause of chronic fatigue syndrome. Most experts do not believe now that chronic fatigue syndrome is due to infection.
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Oral nicotinamide adenine dinucleotide
(Nicotinamide, niacinamide)
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Very poor
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Not recommended. No data about effectiveness available.
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Oral nicotinamide adenine dinucleotide
The one study of this treatment was so poorly done that it did not provide a useful evaluation or credible results.
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Antidepressants
(Prozac/fluoxetine, Nardil/phenelzine, Elavil/amitriptyline, Zoloft/sertraline, others)
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Very poor
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Not recommended. Not effective for CFS symptoms but sometimes prescribed for depression that can occur in reaction to having a long-term illness.
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Antidepressants
Studies of the use of all types of antidepressant medication for CFS symptoms have shown disappointing results. Sometimes, however, individuals with CFS develop depression due to the long-term impact of chronic fatigue and antidepressants may be recommended in this case.
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Evening primrose oil
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Very poor
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Not recommended. Not effective.
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Evening primrose oil
One study showed no benefit.
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Prolonged rest
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Very poor
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Not recommended. May worsen symptoms.
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Prolonged rest
No benefit has been found for rest in chronic fatigue syndrome. In fact, rest seems to worsen symptoms.
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Other treatments
(Homeopathic treatments, massage therapy)
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Not available
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Poorly performed studies. There is no clear benefit to these treatments.
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Other treatments
Several small studies showing possible small benefit were poorly designed and therefore inconclusive.
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NOTE: Just because a drug or combination of drugs can cause a
symptom does not mean it is actually causing your symptom. Symptoms can be caused by
medical conditions as well. Make sure that your physician is aware of any symptoms you
are experiencing so he/she can work with you to determine the cause. Please DO NOT STOP
MEDICATIONS without first consulting a physician since doing so could be hazardous to
your health.
DISCLAIMER: Please note that the information DoubleCheckMD.com provides is intended
to help individuals to work with their medical professionals and is for educational purposes
only. It does not constitute medical or healthcare advice and serves to supplement, not
substitute for, the expertise and judgment of a healthcare professional. In all cases
individuals should consult with a physician before taking any action based on DoubleCheckMD
feedback including, but not limited to ceasing taking any drug, changing diet or commencing or
discontinuing any course of treatment. The information provided by DoubleCheckMD.com is not
intended to cover all possible uses, directions, precautions, drug interactions or adverse
effects, nor should it be construed to indicate that the use of a particular drug is safe,
appropriate or effective.
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