Introduction
Drugs and other interventions can be used in three different ways when it comes to treating almost any illness:
- First is to cure the condition – as when an antibiotic is prescribed to quickly eradicate an acute infection.
- Second is to try and modify what is called the underlying disease process. Good examples here are the use of powerful antiinflammatory drugs in rheumatoid arthritis, or antidepressants to treat chemical imbalances in depression.
- Third is to relieve specific symptoms such as pain or sleep disturbance – something that is normally worth trying in almost any disease, even though the underlying cause of the symptom or disease may not be fully understood.
When it comes to using drugs to treat ME/CFS, there is no curative treatment at present and none on the immediate horizon. The prospect of having a curative treatment will almost certainly have to wait until research provides more substantial information as to what is going wrong in this illness.
However, significant abnormalities have now been identified involving the role of infection, immune-system responses, the nervous system, muscle and mitochondrial function, and hormonal control. These are the type of abnormalities that can be used as the basis for considering and investigating treatments that are aimed at modifying the underlying disease process.
This can involve the development of totally new drugs that are aimed at a specific abnormality (which is extremely expensive to do) or finding new uses for existing drugs – a process known as repurposing. A good example of drug repurposing is the discovery that gabapentin, a drug that is normally used to treat epilepsy, can also be very useful for treating some types of moderate to severe pain.
So, until we gain a much clearer picture about the possible role of disease-modifying drugs in ME/CFS, the main use of drug treatments is going to be for the relief of common symptoms such as pain, irritable bowel and gastric symptoms, sleep disturbance and PoTS (postural orthostatic tachycardia syndrome).
Drugs and other approaches that provide symptomatic relief are already covered in separate ME Association information leaflets and will not be reviewed in any detail in this booklet…
Contents
| How new drugs are assessed and brought into use. | – drugs that can modify the immune system response. |
| Can we treat ME/CFS? | – muscle energy supplements. |
| – activity and energy management. | – nervous system stimulation. |
| – antidepressants. | – vitamins, minerals, probiotics and supplements. |
| – antiviral drugs. | – other drugs. |
| – autonomic nervous system dysfunction and cardiac function. | Prescribing new and experimental forms of drug treatment. |
| – cognitive behavioural therapy. | Looking into the future with the overlaps between ME/CFS and Long Covid. |
| – hormones. |
Dr Charles Shepherd,
Trustee and Hon. Medical Adviser to the ME Association.
DISCLAIMER: Medical information contained in literature from the ME Association is not intended to be a substitute for medical advice or for treatment from your doctor or other healthcare professional. We recommend that you always consult a medical professional about any specific problem and the information we provide is discussed with them before you take any further action.