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Living with M.E.

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Medication

Medication

While there is no pharmacological cure for M.E., there are a number of medications that your doctor can prescribe that may help with individual symptoms.

However, people with M.E. often have a limited tolerance to drugs, so lower doses than usual may be needed.

Different drugs have different effects on symptoms and they also differ in their side effects. If you find that a drug is ineffective or cannot be tolerated, it may be worth systematically trying others, as directed by your GP.


Drugs for pain

A variety of painkilling drugs act in different ways to control different types of pain. These include paracetamol, non-steroidal anti-inflammatory drugs (NSAIDs), opiate based painkillers, tricyclic antidepressants and others.

Painkillers can be very useful, especially if used regularly to prevent pain or to control pain to a tolerable level.

Some individuals may have difficulty in taking a sufficient dose to ease pain. In this case it may be useful to also try other methods of pain control, such as:

  • some supplements and herbs
  • cognitive behavioural therapy (CBT), transcutaneous electrical nerve stimulation (TENS)
  • acupuncture
  • physiotherapy
  • some simple self-help techniques.

Please note that not all these interventions are of proven benefit and some may have side effects.

Our 2014 M.E. time to deliver survey report found that:

  • 65% of respondents used medication for pain
  • 84% reported that it was helpful or very helpful (12% said it made no difference, and 4% said it made them a bit or much worse)

Drugs to improve sleep

Tricyclic antidepressants, eg. amitriptyline, can be helpful in restoring sleep quality and rhythm.

This does NOT mean that M.E. is the same as depression, or that it is a mental illness.

The doses used to help with sleep are much lower than the doses used to help manage depression.

It’s important to start with the lowest possible dose and monitor effects on sleep and daytime tiredness before making any increase in the dose.

Sometimes it may be necessary to try different tricyclic antidepressants to find the one that works best for you with the least side effects. Some antidepressants come in liquid form, which allow very small doses to be taken. These drugs can also help to relieve pain.

Over time, tricyclic antidepressants may show a slightly reduced benefit, at which point modest dose increases can be useful to restore positive effects.

Sedative drugs and ‘sleeping pills’ can help in the short-term to establish a better sleep pattern, especially if you have difficulty getting off to sleep. They range from herbal remedies that you can buy from a chemist or health food shop, through to drugs that are only available on prescription such as zopiclone, zaleplon and zolpidem.

Sedatives can be useful for occasional use, such as before an important event or to break a pattern of poor sleep - but may simply sedate rather than benefit the underlying quality of sleep.

Regular use leads to tolerance (a need for increasing doses to achieve the same effect) and dependence (a reliance on the drug). Even herbal remedies, if used regularly, will require a bigger dose to achieve the same effect.

All sedatives can impair concentration and some can lead to excessive sedation the following day.

Sedative antihistamines including nytol and phenergan, can be bought from a chemist without a prescription. These may be helpful for occasional use but are likely to cause drowsiness the next day.

Benzodiazepines including diazepam (valium), temazepam and nitrazepam are prescription-only drugs. They are best avoided as they are likely to result in dependency.

Our 2014 M.E. time to deliver survey report found that:

  • 53% of respondents used medication to aid sleep
  • of these, 79% reported that it was helpful or very helpful (13% said it made no difference, and 8% said it made them a bit or much worse).

Other medications

Our 2014 M.E. time to deliver survey report found that:

  • 53% of respondents used other medication, eg. for nausea, with 78% reporting that it was helpful or very helpful (11% said it made no difference, and 10% said it made them a bit or much worse).
  • 42% of respondents used medication to help with mood, with 74% reporting that it was helpful or very helpful (15% said it made no difference, and 11% said it made them a bit or much worse).