Background: U.S. prevalence of chronic fatigue syndrome (CFS), also known as myalgic encephalomyelitis (ME), a multisystem neurologic disease and debilitating chronic condition, averaged 1 million to 2.5 million before the COVID-19 pandemic. Incidence rates are now reported to be 15 times greater, related at least in part to long COVID. This retrospective chart review analyzed records of medications and supplements tried before specialty consultation from 571 adults with ME/CFS seen at a Mayo Clinic specialty clinic from 2018 to 2022.
What This Study Found: Medications used commonly for pain, impaired sleep, and mood disorders were the ones most often prescribed before consultation. Medications that have been suggested for core symptoms of ME/CFS, such as fatigue, brain fog, postexertional malaise, orthostatic intolerance, or allergy/inflammation, had less often been tried. Most (72%) of the individuals used at least one supplement.
Implications: The findings suggest potentially helpful medications used by ME/CFS specialists, most of which are well known and used in primary care for other diagnoses, may be under utilized to treat ME/CFS in primary care. To help clinicians navigate available options, researchers created two tables with medications and supplements that ME/CFS specialists commonly discuss with patients in the clinic, organized by symptom category, along with a summary of the current evidence for each.
Underuse of Pharmacologic Therapies for Myalgic Encephalomyelitis/Chronic Fatigue Syndrome Before Specialist Evaluation
Corresponding author: Stephanie L. Grach, MD, MS, et al
Department of Internal Medicine, Division of General Internal Medicine, Mayo Clinic, Rochester, Minnesota
PERMANENT LINK - Will become active after 5 p.m. ET on 05/26/26
