Newly released paper discusses treatment strategies for ME/CFS, cites the importance of clinical intuition
By Suzanne D. Vernon PhD
In 2012 I organized a meeting at the Banbury Center, Cold Spring Harbor Laboratory. The objective was to bring together medical and scientific experts to strategize on accelerating treatments for ME/CFS. It was decided that understanding the “clinical intuition” doctors use to manage and treat ME/CFS patients would help identify ways to accelerate FDA-approved treatments. Drs. Spyros Deftereos and Andreas Persidis – who were working on a drug repurposing study – volunteered to create a private online survey to send to ME/CFS expert physicians to complete.
Eleven physicians responded to the survey and the results are published in the January issue of Fatigue: Biomedicine, Health & Behavior. In this paper my co-authors Spyros N. Deftereos, Andreas Persidis and I present the results of the survey. This article contains treatment information that may be of interest to your doctor.
If you miss getting the full text download, the abstract nicely summarizes the survey results too.
Access it HERE
Respondents were asked to rate drugs as very effective, moderately effective, somewhat effective, little effect or not effective, for the treatment of 18 symptoms including those most problematic in ME/CFS.
- Stimulants (Armodafinil, Modafinil, Amphetamines), low dose bupropion and vitamin B12 injections were moderately effective at treating fatigue and brain fog.
- Trazodone was moderately effective for sleep problems.
- Citalopram and fentanyl were very to moderately effective for treating the symptoms of depression, arthralgia and muscle aches.
- Fludrocortisone was somewhat effective for orthostatic intolerance and POTS.
- Physician’s responded that the majority of drugs are somewhat effective, little effect or not effective to treat ME/CFS associated symptoms.
The experts were also asked to comment on the strategies they use to treat ME/CFS and here is what they said:
- “Most respondents agreed that CFS symptoms are more often interrelated than not, and that treatment should address the most troubling symptoms first.”
- “Sleep improvement may also ameliorate post-exertional malaise, pain and headache.”
- “Treatment of orthostatic intolerance can ameliorate fatigue, light headedness, mental fog, headache and pain.”
- “A triad of epigastric pain, reflux and early satiety may suggest hypersensitivity to milk or other food protein.”
While there is no cure, MECFS/FM patients seen by Dr. Bateman and her medical staff here at the Bateman Horne Center, often tell us they are much better than they used to be. Though each patient is unique, when it comes to practical treatment advice, Dr. Bateman has incredible clinical intuition for treating those with MECFS/FM, honed by treating hundreds of patients with these conditions.
Dr. Bateman has put together a simple MECFS/FM_Treatment_Advice document that you can access HERE. She uses these treatment approaches with her patients and routinely teaches other medical professionals this simple plan of chronic management for MECFS/FM patients. Her aim is to provide a practical way to continually address symptoms that appear ordinary on the surface but may actually be aspects of illness physiology.
Her advice can improve symptoms and daily function, but also returns autonomy and empowerment to the patient until science identifies objective biomarkers and develops treatments more specifically directed at disease mechanisms. Achieving best management of MECFS/FM manifestations also places this person in the most “research ready” position and gives them a chance to be part of these scientific advances.