Use of medications among people with chronic fatigue syndrome and healthy persons: a population-based study of fatiguing illness
Use of medications among people with chronic fatigue syndrome and healthy persons: a population-based study of fatiguing illness in Georgia
Chronic fatigue syndrome (CFS) is a debilitating condition of unknown etiology and no definitive pharmacotherapy. Patients are usually prescribed symptomatic treatment or self-medicate. We evaluated prescription and non-prescription drug use among persons with CFS in Georgia and compared it to that in non-fatigued Well controls and also to chronically Unwell individuals not fully meeting criteria for CFS.
A population-based, case-control study. To identify persons with possible CFS-like illness and controls, we conducted a random-digit dialing telephone screening of 19,807 Georgia residents, followed by a detailed telephone interview of 5,630 to identify subjects with CFS-like illness, other chronically Unwell, and Well subjects. All those with CFS-like illness (n=469), a random sample of chronically Unwell subjects (n=505), and Well individuals (n=641) who were age-, sex-, race-, and geographically matched to those with CFS-like illness were invited for a clinical evaluation and 783 participated (48 % overall response rate).
Clinical evaluation identified 113 persons with CFS, 264 Unwell subjects with insufficient symptoms for CFS (named ISF), and 124 Well controls; the remaining 280 subjects had exclusionary medical or psychiatric conditions, and 2 subjects could not be classified. Subjects were asked to bring all medications taken in the past 2 weeks to the clinic where a research nurse viewed and recorded the name and the dose of each medication.
More than 90% of persons with CFS used at least one drug or supplement within the preceding two weeks. Among users, people with CFS used an average of 5.8 drugs or supplements, compared to 4.1 by ISF and 3.7 by Well controls. Persons with CFS were significantly more likely to use antidepressants, sedatives, muscle relaxants, and anti-acids than either Well controls or the ISF group. In addition, persons with CFS were significantly more likely to use pain-relievers, anti-histamines and cold/sinus medications than were Well controls.
Researchers and medical care providers of patients with chronic fatigue syndrome should be aware of polypharmacy as a problem in such patients, and the related potential iatrogenic effects and drug interactions.
Reference: Boneva RS, Lin JM, Maloney EM, Jones JF, Reeves WC, Use of medications among people with chronic fatigue syndrome and healthy persons: a population-based study of fatiguing illness in Georgia, Health Qual Life Outcomes. 2009 Jul 20;7(1):67.
Additional Aspects:
Medication
It is a feature of CFS that standard prescription medications often make patients/sufferers worse. Many sufferers know they are intolerant of alcohol and caffeine which may reflect slow ability to detoxify – this may also be a reason for intolerance of prescription medication. The commonest problems I see are:
• Standard doses of medication are not tolerated and the sufferer sees many side effects – this may reflect slow detox or poor micronutrient status.
• Intolerance of medications – may reflect a tendency to allergies and multiple chemical sensitivity
• Antibiotics causing thrush/yeast problems
• Statins making symptoms much worse – possibly because statins inhibit endogenous production of co Q 10 (see below)
• Beta blockers making fatigue much worse – this is because in severe CFS the patient is in a low cardiac output state (secondary to mitochondrial failure) and beta blockers exacerbate this.
Explanation of Mitochondrial Failure by Dr. Sarah Mhyll to Dr. Rigau (Part 3)
http://www.bukisa.com/articles/126106_explanation-of-mitochondrial-failure-by-dr-sarah-mhyll-to-dr-rigau-part-3