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.
The following prescription drugs show promise in assisting sleep in chronic fatigue syndrome. See the chart below for physician recommendations.
Klonopin (Clonzepam) – Several chronic fatigue syndrome (ME/CFS) physicians report Klonopin is among the most effective therapies they use. For a special focus on Klonopin Click Here.Trazodone (Desyrel) (50 mg. nightly) - Six physicians recommended Trazodone. Dr. Lapp reports that he has ‘excellent luck’ with Trazodone and Dr. Bell states that "Trazodone is one of my most favorite medications for sleep. "Trazodone doesn’t cause dry mouth or stimulate the appetite (no weight gain) and puts you into deep stage three or four sleep. Since it works best in the early morning hours it is a good medication for those who wake early and can’t get back to sleep. It also helps with anxiety. Men may find that it may help with erections. Dr. Bell states it should be taken ½ hour to two hours before sleep.
Dosage: Dr. Bell starts at 25 mg. (taken ½-2 hours before sleep) and works his way up (50-150mg.). Dr. Lapp recommends 50 mg. Dr. Bell states it should be taken approximately one-half hour to two hours prior to going to bed.
Xyrem - For a special focus on Xyrem click here
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 |
|
Bateman |
Ambien, Sonata, Lunesta, Restoril, Melatonin, Rozarem, Zyprexa |
Trazodone, Remeron, Neurontin, Lyrica, Amytriptyline |
|
Bell |
Flexeril, Carisoprodol, Elavil, Klonopin, Ambien, Sonata |
Trazodone |
|
Klimas |
Sinequan (Doxepin) elixir, Elavil, Flexeril, Klonopin |
|
|
Lapp |
Clonzepam, Sonata, Lunesta, Ambien, Klonopin |
Trazodone, |
|
Levine |
Sinequam (Doxepin), Klonopin |
Trazodone, Amytriptyline, Norpramin, Neurontin, Cyclobezaprine |
|
Pocinki |
Ambien/Ambien CR |
Amitryptyine, Trazodone |
|
Rosenbaum |
Elavil, Sinequan (Doxepin) elixir, Sonata |
|
|
Teitelbaum |
Ambien, Klonopin, Sinequam, Flexeril, Zanaflex | Trazodone, Neurontin, Sonata, Amitryptyline |
|
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.
______________________________________
David S. Bell, M.D.,
Charles Lapp, MD., 1999. “The Treatment of Chronic Fatigue Syndrome and Fibromyalgia”. ImmuneSupport.com,
Carol Sieverling. 2000. Paul Cheney, M.D on Klonopin – Protecting Your Brain. by Carol Sieverling from the CFIDS and
Jacob Teitelbaum, 2007. From Fatigued to Fantastic, Avery Publishers.
