ADHD Drugs for Chronic Fatigue Syndrome - How Well Do They Work?

[Trish]

I find that, even with caffeine - it hypes me up so I get a false sense of energy that if I act on it leads to crashes. And it makes my heart race and skip beats, and keeps me awake.

 

[soti]

I echo the words of caution but I would also like to throw something in here. Stimulants are sometimes prescribed (off-label) to treat POTS brain fog. Many pwme have POTS. In my own experience, methylphenidate is great for that. It does nothing for my wooziness, nor for my PEM, but getting cognitive functionality back is fantastic. But I can't use it every day or it slowly stops working.

 

[Webdog]

Glad to see the CDC does warn that stimulants could lead to over-exertion, resulting in crashing. I think it means PwME should be extremely cautious/wary of taking these, because if all stimulants do is dull the body's warning signs, then that may result in overconfidence and consequences.

Agreed. However, doctors need to be trained on how to diagnose ME/CFS for it to do any good. These guidelines do little for the undiagnosed ME/CFS patient misdiagnosed with idiopathic fatigue and ADD.

Not to mention that throwing stimulants at such a patient might cause side effects that make them depressed.

 

[Webdog]

Another article with a short mention of ADHD drugs for "Chronic Fatigue Syndrome".

An observational case study by Young et al suggested this when they found that ADHD patients with unexplained fatigue, widespread musculoskeletal pain, or a preexisting diagnosis of chronic fatigue syndrome or FMS, not only had improved symptoms of ADHD on stimulant medication, but also improvement of pain and fatigue, van Rensburg wrote.

http://www.ajmc.com/newsroom/study-suggests-screening-patients-with-fibromyalgia-syndrome-for-adhd-

Since the mentioned "observational case study" isn't listed in the references, I assume it was never published. Sounds pretty wishy-washy to me.

 

[alex3619]

Do you think that the only studies of ME/CFS that we should consider valid are those that use CCC or ICC? That would eliminate almost all the work in this field.

Yes, and most of that work needs to be replicated in well defined cohorts, or ignored. All Oxford studies can be ignored. Fukuda is well past its use by date. Most studies in ME/CFS are not conclusive or not replicated. Few studies with well defined ME patients are done. Only exploratory studies with in-depth analysis can afford broad cohorts. I wish researchers would use CCC or ICC and for clinical interventions would require objective outcome measures, preferably multiple objective measures.

As soon as we have validated biomarkers much of the CFS and ME research will be in question. It will be time to take a whole new look at all of it. If distinct subsets exist then the research must be designed to take that into account. Knowing exactly what type of patient is being investigated is a game changer.

 

[Russell Fleming]

The Synergy Trial at Stanford "evaluated the safety and efficacy of methylphenidate (generic Ritalin), combined with a mitochondrial support nutrient formula over 12 weeks".

"The difference between the two groups did not achieve statistical significance".

http://solvecfs.org/preliminary-results-from-synergy-trial-released/

What do you make of today's press release from the authors of the Synergy Trial:

The Synergy Trial was a double-blinded, placebo-controlled study that enrolled 128 participants with moderate to severe ME/CFS. The trial was conducted at four research sites in the United States including, the ME/CFS Initiative at Stanford University, California, the Bateman Horne Center in Salt Lake City, Utah, The Sue Levine Medical Clinic in NYC, and the Dept. of Clinical Immunology, Nova Southeastern University, Ft. Lauderdale, Florida. The trial was funded by K-PAX Pharmaceuticals and the lead investigator was Stanford University Professor, Dr. Jose Montoya (see bio below).

The study's results identified that KPAX002 was most effective in subjects with more severe ME/CFS symptoms and those with both fatigue and pain; two key subgroups that responded best to the treatment. ME/CFS patients in these groups had more than double the level of improvement after treatment with KPAX002 as patients taking the placebo. KPAX002 was also found to be safe and well tolerated.

https://www.prnewswire.com/news-rel...chronic-fatigue-syndrome-mecfs-300633260.html

 

[JohnM]

What do you make of today's press release from the authors of the Synergy Trial:

The press release is not from the authors themselves, but is a release by K-PAX .. further discussion can be found here Russell.

Wishing everyone improved health and every happiness. John

 

[WillowJ]

thank you @zzz for the link to the table. That was very helpful.

Deleted message where I hadn't read enough of the study.

 

[InfiniteRubix]

Merged thread

Possible Link Between Chronic Fatigue Syndrome and ADHD

By
Adrienne Dellwo
Medically reviewed by
Grant Hughes, MD
Updated on January 18, 2020

Possible Link Between Chronic Fatigue Syndrome and ADHD
On the surface, chronic fatigue syndrome (ME/CFS) and attention deficit/hyperactivity disorder (ADHD) look like complete opposites: One means you have to stay inactive much of the time, and the other one makes you constantly active. They couldn't have much of anything in common, right?

Actually, they just might.

https://www.verywellhealth.com/chronic-fatigue-syndrome-adhd-whats-the-link-3972913

Not an endorsement, regardless of my curiosity. There does seem to be an air of overconfidence in the article. Not looked at the underlying citations, diagnostic criteria used/not used, recovery measures, etc.

Smells a bit of pharma marketing...

Even if there is ever a connection found one day, it very much feels like a classic correlation vs causation mess, causative process over-implication, writer overexcitment.

 

[InfiniteRubix]

My usual typo habits fixed

 

[InfiniteRubix]

As alluded to, also suspicious that this is an area ripe for abuse of poor diagnostic criteria and lack of non neurodiverse controls

 

[rvallee]

Merged thread

Possible Link Between Chronic Fatigue Syndrome and ADHD



https://www.verywellhealth.com/chronic-fatigue-syndrome-adhd-whats-the-link-3972913

Not an endorsement, regardless of my curiosity. There does seem to be an air of overconfidence in the article. Not looked at the underlying citations, diagnostic criteria used/not used, recovery measures, etc.

Smells a bit of pharma marketing...

Even if there is ever a connection found one day, it very much feels like a classic correlation vs causation mess, causative process over-implication, writer overexcitment.

I don't see how any medical professional could tell the difference between ADD and brain fog, they don't even acknowledge brain fog as a real thing so there would never be any such comparison to make. There is no reliable test or process for either, at best it's indicative of in most cases. It's not as if we understand a single thing about either so that's basically comparing one angel dancing on hairpins with another angel dancing on hairpins. Are they doing pirouettes or a tango? Sure, why not?

If there's an overlap it would be over misdiagnosis. Which is very common so that's basically Occam's razor here.

 

[InfiniteRubix]

Re ADD, absolutely agree. The overlap with brain fog is observationally sufficient that one could reasonably argue either is one or the other.

The hyperactivity of ADHD will be observable, but what one can rightly interpret from such a determination or do with it is a can of worms, even without ME (forgetting claim of link).

I remain convinced that some neurodiverse people will have an extra energy burn/drag pre, during and post ME onset that can't be irrelevant to them. But that's not a statement of connection, merely that they have extra cognitive and/or emotional energy drag. But that's no different in principle to being more likely because someone has a bad hip!