Chronic Fatigue: Antidepressants

Topic Overview

Antidepressants do not cure myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). They may relieve symptoms such as fatigue, sleep problems, difficulty concentrating, and pain. But they will not affect the course of the illness or the speed of recovery.

Antidepressants that are commonly used to treat (ME/CFS) include:

• Selective serotonin reuptake inhibitors (SSRIs), such as fluoxetine (for example, Prozac), paroxetine (Paxil), sertraline (Zoloft), citalopram (Celexa), and escitalopram (Lexapro).
• Tricyclic antidepressants, such as amitriptyline, desipramine (Norpramin), imipramine (Tofranil), and nortriptyline (Pamelor).
• Other antidepressants, such as bupropion (Wellbutrin), trazodone, venlafaxine (Effexor), and mirtazapine (Remeron).

When these medicines are used to treat ME/CFS, they may be given in lower doses than the amounts used to treat depression.

The choice of medicine may depend on the symptoms that are most bothersome, because each medicine has somewhat different side effects. For example:

• If you have trouble sleeping, you may need a medicine to take at bedtime that causes drowsiness.
• If you have trouble concentrating on daily tasks, you may need a medicine to take during the day that can help with concentration and clear thinking.

If depression has been diagnosed along with ME/CFS, antidepressants may be used to treat depression also.

The U.S. Food and Drug Administration (FDA) has issued an advisory on antidepressant medicines and the risk of suicide. Talk with your doctor about these possible side effects and the warning signs of suicide.

Do not suddenly stop taking antidepressants. These medicines must be gradually tapered off under your doctor's supervision.