The Alternative therapies' subforum isn't a great place to put this question, but I can't find a better place. The online guidance to doctors that I am reviewing has the following section about the use of antidepressants as treatments for ME/CFS: 1. The use of antidepressants in CFS has not shown a significant benefit:2 · There can be similarities in symptoms between CFS, depression, and fibromyalgia. In some patients with overlapping symptoms, consider a trial of antidepressants. Trial of antidepressants · Local specialist opinion suggests there appears to be a subgroup of patients with chronic fatigue syndrome (CFS) who may respond to antidepressants even though they do not meet the criteria for a diagnosis of depression. An SSRI is an appropriate first-line agent. · If an antidepressant is trialled, advise patients that an immediate response is not expected and can take several weeks. · Antidepressants may themselves provoke or exacerbate fatigue and should be discontinued in patients who do not demonstrate symptom improvement within a reasonable time frame (e.g., 6 to 8 weeks). · Tricyclic antidepressants may be useful in low doses for symptom control for pain and insomnia. The possibility of depression as a consequence of having a chronic disease and the possible need for counselling regardless of whether there is clinical depression or not are covered elsewhere in the document. So this part of the guidance doesn't need to cover the treatment of identifiable depression. Has anyone found that anti-depressants have had a positive impact on their ME symptoms including pain and insomnia? If so, what cautions would you note about their use? Are there any good studies relevant to this question? Thanks!