Medication Use and Symptomology in North American Women with ME/CFS, 2025, Pochakom et al

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Medication Use and Symptomology in North American Women with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome, 2025, A Pochakom, G Macnevin, RF Madden, AC Moss, JM Martin, S Lalonde-Bester, J Parnell…

Background: There are no known curative treatments for myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), and current therapeutic regimens often yield inconsistent results. Despite the profound physical and mental burden experienced by those living with ME/CFS, patients often face a trial-and-error process in finding medications that offer some relief.

This study surveyed 135 North American women diagnosed with ME/CFS to characterize medication use in relation to disease features, symptomology, and function.Medications were classified into 9 categories according to their primary mechanism of action and therapeutic use.Participants were primarily middle-aged (47.1± 5.3 years) and were diagnosed for a mean duration of 8.4±9.5 years (mean±SD).

Responses showed 68.6% of participants reported taking medications specifically for ME/CFS. Of those taking ME/CFS-related symptom medications, the average use was 3.0 medications per patient, with higher use in US compared to Canadian participants. Analgesic medications (31.7%) were the most frequently used, followed by psychotropic (26.4%), and immune-related medications (10.6%).These trends persisted across different symptom profiles, apart from gastrointestinal associated medication use replacing immune related medications in those with gastrointestinal, neurological, and psychiatric symptoms.

There was no significant correlation found between the number of medications used with disease duration, age, or age at diagnosis. However, a U-shaped relationship between ME/CFS-related symptom medication use and functional capacity as assessed by self-reported physical movement (hours/week) was evident. Conclusions: Our study highlights the diverse and complex patterns in pharmacological treatment regimens for ME/CFS in women, while also underscoring the need for more tailored and evidence-based therapeutic strategies to address the varied symptom profiles.

Brief Research Report article. The final, formatted version of the article will be published soon.

https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2025.1543158/abstract
doi: 10.3389/fmed.2025.1543158

 

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Now published: Link | PDF

 

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The use of psychotropic medications was also widespread in our study, potentially highlighting the considerable impact of depression and psychological stressors on ME/CFS patients. Another aspect may be the historical tendency to characterize ME/CFS as a psychiatric disorder rather than a physical disease, which has frequently led to the prescription of antidepressants as a primary treatment (17). Some patients in our study have lived with an ME/CFS diagnosis for up to 34 years, and since awareness of the condition’s non-psychiatric origins are relatively recent, the numerous antidepressant prescriptions may be a result of former views held by physicians. This is potentially concerning, given the inconclusive evidence regarding the effectiveness of antidepressants for treating ME/CFS specifically. For instance, some clinical trials have reported that SSRIs are ineffective and may even worsen fatigue in ME/CFS patients (27, 28). Additionally, emerging evidence suggests that central serotonin hyperactivity may play a role in the pathogenesis of ME/CFS, which contrasts the low levels of serotonin activity typically seen in depressive disorders (29). As such, it is reasonable to question the use of antidepressants to treat the core symptoms of ME/CFS, and current recommendations do not support their use in patients without depressive symptoms (30).

It makes you think about how many have been prescribed in ineffective or even worsening medications. Stopping antidepressants can come with a whole host of side effects too. This may put people off stopping them.

 

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The use of psychotropic medications was also widespread in our study, potentially highlighting the considerable impact of depression and psychological stressors on ME/CFS patients

It doesn't, though. Such a bizarre statement. And yet, in the very next sentence is the explanation:

Another aspect may be the historical tendency to characterize ME/CFS as a psychiatric disorder rather than a physical disease, which has frequently led to the prescription of antidepressants as a primary treatment

So what it says is that there is such a belief among health care professionals, who can't tell the difference between illness and mood without the help of technology. It says nothing about the illness or the patients, though, just the common beliefs in the industry.

Well, the reasoning is a bit off, but the facts are at least plainly detailed:

This is potentially concerning, given the inconclusive evidence regarding the effectiveness of antidepressants for treating ME/CFS specifically

Basically what this says is that medicine is a mess when it comes to chronic illness. Which is known, but is entirely ignored from discussion, because introspection is just not part of how medicine operates. And although many physicians would disagree with that, if it did, then none of this would be happening, so it really speaks for itself.

Odd how obsessing over failed ideas doesn't achieve anything. Who knew?