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ADD/ADHD Drugs for Chronic Fatigue Syndrome

How Well Do They Work?

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Updated October 27, 2011

Written or reviewed by a board-certified physician. See About.com's Medical Review Board.

Could drugs meant for hyperactive children be an effective treatment for chronically fatigued adults? Is illogical as it sounds, they might be.

Some doctors prescribe ADD/ADHD drugs for their patients with chronic fatigue syndrome (ME/CFS) and say they've seen positive results. We have some studies to back this up -- at least in a subgroup of ME/CFS -- but a lot more research is needed.

These drugs are classified as neurostimulants, which means that they stimulate brain activity. The most popular neurostimulants are:

  • Ritalin and Concerta, which contain methylphenidate
  • Dexedrine, which contains dextroamphetamine
  • Adderall, which contains amphetamine and dextroamphetamine

Why Use Neurostimulants?

The exact mechanism of these drugs isn't known (which is actually quite common in drugs that affect the brain), but they're believed to change the availability in the brain of norepinephrine and dopamine, two neurotransmitters that are possibly dysregulated in both ADD/ADHD and ME/CFS.

Low norephinephrine is linked to loss of alertness and memory problems, while dopamine deficiency is linked to cognitive impairment and inability to focus attention. These symptoms are shared by ADD/ADHD and ME/CFS.

One small study demonstrates that, in adults, the two conditions share a lot of other symptoms as well, including unexplained fatigue, widespread muscle pain, and diagnoses of ME/CFS or the similar condition fibromyalgia. Some doctors even hypothesize that children with ADD/ADHD may be at risk for developing ME/CFS as adults.

Some drugs used for fibromyalgia also impact the availability of norepinephrine. These drugs include Cymbalta (duloxetine) and Savella (milnacipran), two of the three FDA-approved fibromyalgia treatments. These drugs are classified as serotonin-norepinephrine reuptake inhibitors (SNRIs). SNRIs haven't been well researched for ME/CFS, but they are widely prescribed, in part because many doctors believe fibromyalgia and ME/CFS are the same or closely related conditions.

A 2006 study of methylphenidate for ME/CFS demonstrated a significant improvement in about 20% of participants. That's hardly an overwhelming endorsement. However, many researchers believe ME/CFS consists of several subgroups that each require different treatment. Do the people who responded to methylphenidate represent a particular subgroup? We don't yet know enough to say either way.

A 2003 preliminary study of dextroamphetamine showed that 9 out of 10 participants with ME/CFS had significantly less fatigue while taking the drug compared to a placebo. However, further research has not been published.

A 2008 review of neurostimulants for ME/CFS called these drugs "potentially promising." Still, more research is needed.

These medications are already on the market and are relatively inexpensive, which makes them easy for people to obtain. A drawback is that they carry a risk of addiction and therefore may require frequent doctor's appointments.

More Information

For more information on neurostimulants, including possible side effects, see:

  • Ritalin (methylphenidate)
  • Concerta (methylphenidate)
  • Dexedrine (dextroamphetamine)
  • Adderall (amphetamine, dextroamphetamine

Sources:

Blockmans D, et. al. The American journal of medicine. 2006 Feb;119(2):167.e23-30. Does methylphenidate reduce the symptoms of chronic fatigue syndrome?

Olson LG, Ambrogetti A, Sutherland DC. Psychomatics. 2003 Jan-Feb;44(1):38-43. A pilot randomized controlled trial of dexamphetamine in patients with chronic fatigue syndrome.

Valdizán Usón JR, Idiazábal Alecha MA. Expert review of neurotherapeutics. 2008 Jun;8(6):917-27. Diagnostic and treatment challenges of chronic fatigue syndrome: role of immediate-release methylphenidate.

Valdizán Usón JR, Idiazábal Alecha MA. Expert review of neurotherapeutics. 2008 Jun;8(6):917-27. Diagnostic and treatment challenges of chronic fatigue syndrome: role of immediate-release methylphenidate.

Young JL, Redmond JC. Psychopharmacology bulletin. 2007;40(1):118-26. Fibromyalgia, chronic fatigue, and adult attention deficit hyperactivity disorder in the adult: a case study.

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