IACFS/ME Conference – Dr Hector Bonilla on “Case Presentation: Treating ME/CFS with Aripiprazole”

The 2^nd Virtual Scientific Conference for the International Association for Chronic Fatigue Syndrome/ Myalgia Encephalomyelitis was held on the 19^th – 21^st August 2021 (streamed on zoom). The conference promoted unpublished data and included both clinicians and biomedical researchers. 

The talks were grouped into different sections, including the longer 45 minute talks in the Professional Workshops and shorter talks covering topics of infectious diseases, immunology and clinical cases. 

We have chosen a selection of the talks which will hopefully be of interest to you, these are listed below. Here we report on our tenth talk in this series with a talk from Dr Hector Bonilla who talked about dramatic improvements in symptoms using Aripiprazole, with his presentation titled “Case Presentation: Treating ME/CFS with Aripiprazole”. The further talks we will cover are shown below and these will be available in one report by the end of October 2021. 

Due to the format of the conference and the focus on unpublished data, no direct recordings or pictures are available freely as this may jeopardise publication. The full conference programme can be found on the IACFS/ME website here, where recorded presentations may be purchased. 

10. Case Presentation: Treating ME/CFS with Aripiprazole  

Hector Bonilla, MD  
Stanford University; Stanford, CA, USA  

Dr Hector Bonilla presented a case study of a 65-year-old male, who’s onset of CFS started in 2007 (14 years ago). Before the onset of CFS he was a very active family man into outdoor sports. Following the onset of the illness he visited multiple doctors and was seen as physically fit and healthy. He underwent cognitive behavioural therapy (CBT) and graded exercise therapy (GET).  

Following a trip to the cinema, symptoms worsened and he had a severe 6 month long crash. He had further extensive investigation of symptoms such as MRI, bloods and EEG. The patient tried an extensive range of treatments, including having a pacemaker, diet changes, acupuncture, antivirals and anti-inflammatory drugs. He received many other diagnoses along the way, such as psychogenic seizures. 

In 2019, he was started on a low dose of Aripiprazole (0.5mg) and a dramatic improvement was seen in only two weeks. The dose was increased over a 4-month period (1.75mg) and he reports an amazing improvement “feeling like a new man”. He reported improvement in symptoms, including: no crashes, increased concentration, and no non-epileptic seizures.  

Dr Bonilla reported on a study of 101 ME/CFS patients who were treated with aripiprazole. The study saw a 75% response rate with an average dose of 1.2mg (in the patients that were seen to respond). The patients which were seen to respond had dramatic improvements in fatigue, brain fog and unrefreshing sleep (Crosby et al., 2021). 

Dr Bonilla ended by proposing the possible mechanisms which could be involved in the improvements seen. These mechanisms include: decreasing inflammatory cytokines, reduced microglial cell activation, targeting RNA expression (through being an immunomodulator drug) and dopamine mediated mechanisms.  

(Please note: The ME Association does not recommend that anyone with ME/CFS attempts to obtain or to take this drug, even in small doses, until such time as more appropriate research – double-blind placebo controlled clinical trials – can better determine safety and efficacy. Read more here) 

Katrina Pears, Research Correspondent, ME Association