MEDICAL MATTERS
- Medical Matters features questions asked by Members of the ME Association on health-related topics.
- Dr Charles Shepherd and the ME Association's other advisers answer these questions by sharing their expert knowledge.
- Medical Matters is based on the popular ‘Ask the Doctor’ series in ME Essential magazine.
- It is a free resource that supplements the detailed information contained in the full range of literature that can be found in the website shop.
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Questions in the Category: Antidepressants
Symptoms: Pins and Needles
I’m in my early forties and have had moderate ME/CFS for about 5 years. I have all the usual symptoms but I now have a new and rather distressing sensation in my arms and sometimes in my legs. It is very similar to the ‘pins and needles’ sensation you can get when your legs have been crossed for too long. These abnormal sensations come and go and don’t seem to be triggered by anything in particular. Is this yet another symptom of ME/CFS? Or do I need to go and see my doctor?
Symptom: Mild heat stroke
Recently I went to the seaside for the day. It was very hot and I felt it was too much for me, so I went down to the sea to cool off – just paddling in the water (which was surprisingly cold – in fact, downright chilly). It was fine initially but then I started to feel off-balance and then ill, and had to get back to the car quickly (and I had to sit down on the way several times) and then lie down on the back seat of the car. What might have caused such a reaction?
Treatment: Selective Serotonin Reuptake Inhibitors
My doctor has suggested that I might like to try using a drug called sertraline (trade name is Lustral). I know it’s normally used to treat depression but he says that it may be worth trying because ME can upset the levels of chemical transmitters in the brain and this drug can help to increase the level of one called serotonin. Is this drug safe? And is there any evidence that it can be used to treat ME?
Symptom: Vivid Dreams
Are vivid dreams a recognised symptom of ME? Like most people with ME I have unrefreshing sleep and sometimes wake up in the night. But I’ve recently been waking in the middle of the night with very clear memories of rather bizarre vivid dreams. Fortunately, nothing frightening has happened so far!
Treatment: Tryptophan
I’ve read that taking a tryptophan supplement is helpful for people with ME. Is this true? And are there any side-effects?
Mental Health: Anxiety and Panic Attacks
I’ve always been a rather anxious person but this has become more noticeable since developing ME. I also have occasional panic attacks – which never happened before. Is this all part of having this illness? Or am I just being unlucky?
Treatments: Drugs – Sensitivities & Side-effects
This is more of a warning than a question. Earlier this year I experienced a rapid and noticeable deterioration in the fatigue part of my ME/CFS. I was also getting muscle cramps – a new symptom to add to the list. All of this coincided with a prescription from my doctor for water losing tablets (diuretics) to treat high blood pressure. At first, she didn’t think there was any connection. But after doing some blood tests it turned out that I had a low level of potassium – something that can occur as a side-effect of using this type of drug. After a change in medication, my potassium level returned to normal and my ME/CFS symptoms also improved. So it’s worth noting that drugs can sometimes cause a significant exacerbation of symptoms for people with ME/CFS.
Mental Health: Depression
Like many other people with ME/CFS, I often feel fed up and frustrated by all the restrictions this illness imposes on my life. But I don’t feel depressed. I now have a new bright GP who thinks I am depressed and he wants me to try a course of antidepressants – to see if they make me feel happier! I know I would feel happier if I just felt well again. But I’m not convinced that I need antidepressants to do so!
Treatment: Drugs and Weight Gain
Although taking a low dose amitriptyline has been very useful in reducing some of my pain and helping to correct my very erratic sleep pattern (frequent wakening during the night) I’ve put on a considerable amount of weight since taking this drug. My GP says that weight gain is a well recognised side-effect with this type of drug and that it can also occur with other drugs that are used for pain relief. I know from talking to other people with ME that weight gain can be a major problem with some drug treatments for ME. But why is this so? And are there any solutions?
Dr Charles Shepherd
Dr Shepherd has been Trustee and Hon. Medical Adviser to the ME Association for more than 40 years. He is integral to the charity's activities and provides information and support based on his professional knowledge, personal experience as a doctor with ME/CFS, and the understanding gained from helping many thousands of people with the condition. He was a member of the comittee responsible for the 2021 NICE Clinical Guideline and is a recognised expert on ME/CFS in the UK. His knowledge extends to Post-Viral Fatigue Syndromes (PVFS), Myalgic Encephalopathy/Encephalomyelitis (ME), Chronic Fatigue Syndrome (CFS), and Post-Acute Sequelae of SARS-CoV-2 infection (PASC) or Long Covid.
If you have questions about ME/CFS or Long Covid, you can:
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Medical Matters is based on the popular ‘Ask the Doctor‘ series featured in the highly-regarded member’s magazine, ME Essential, and in the healthcare professional magazine, ME Medical. Both are produced by the ME Association and published as hard-copy magazines every 3 months and sent to members and healthcare professionals by post to home or business addresses.
If you are an HCP you can sign-up here to receive ME Medical magazine (people with ME/CFS can also nominate their HCP by completing the sign-up form).
