How to Use Serotonin for Chronic Fatigue Syndrome
Chronic fatigue syndrome (CFS), also called chronic fatigue and immune dysfunction syndrome, is named for its most obvious symptom. It often seems like a mysterious illness. No cause has been found for it, and while it often seems to disappear on its own, no cure has been found either. Treatment focuses on symptoms, and how serotonin is metabolized is one of those symptoms.
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Instructions
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Test to determine the patient's serotonin level. If it's below normal levels, treat the CFS patient with one of two classes of drugs that will increase the serotonin level: selective serotonin reuptake inhibitors (SSRIs) and selective serotonin/norepinephrine inhibitors (SNRIs). Both classes work by inhibiting the brain's ability to remove serotonin from the bloodstream.
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Determine if your patient is having difficulty sleeping. Some SSRIs, including nefazadone (sold as Serzone), can help the patient sleep. Other SSRIs, like sertraline (Zoloft) can cause some interference with sleep patterns, however.
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Ask your patient about her pain level. Some SSRIs and SNRIs, including the SNRI venlafaxine (Effexor) can increase the patient's pain threshold and help control pain.
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Discuss your patient's energy level with him. While sertraline can interfere with sleep, it can also increase your patient's energy during the daytime, as can other SSRIs like fluoxetine (Prozac).
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Consider which problems bother your patient the most, and choose an SSRI or SNRI based on your conclusion. Begin with a very low dose, one-half to one-third of the dosage used with depressed patients. Use it for at least six weeks to learn if the medication will help your patient. If your patient can't tolerate the drug's side effects, try a different one.
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Increase your patient's dosage only if the medication has worked but has become less effective over time.
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Tips & Warnings
SSRIs and SNRIs were developed as antidepressant medications. In lower doses, they've helped patients with CFS, who don't suffer from depression. Since depression can develop after years of dealing with a chronic illness, antidepressants should be considered carefully for use in CFS patients.
The U.S. Food and Drug Administration has issued a public health advisory about the combination of SSRIs and SNRIs with triptans, a class of drug widely used for treating migraine headaches. If used together, they can cause a potentially deadly condition known as serotonin syndrome. If you take both types of drugs, discuss their continued use with your physician.
SSRIs and SNRIs haven't been adequately studied in children and young adults. They've caused suicidal thoughts and behaviors in children and teens, so their use in patients under 25 years old is not recommended, even at the lower doses used for CFS.
