Individualizing medical treatment in chronic fatigue syndrome/ myalgic encephalomyelitis: Evidence for effective medications and possible relevance to “Long-Hauler Syndrome” in Covid-19 affected patients

Abstract

Large controlled studies of Chronic Fatigue Syndrome/Myalgic Encephalomyelitis (CFS/ME) have shown no effective medical treatment for this disorder. There are individual patients, however, with dramatic responses to some medications. We report two patients with clear responses to rintatolimid and galantamine characterized by rapid reduction of symptoms on starting treatment and return of symptoms on withdrawal. As in cancer, CFS/ME is a heterogeneous disorder but unlike most cancers, such as melanoma, breast cancer, and B-cell lymphoma, CFS/ME has no known biological marker that can distinguish between subtypes. We suggest an approach to medical treatment of CFS/ME that could be utilized by primary caregivers that offer the possibility of more rapid and complete recovery from this debilitating disorder. Current studies indicate that prolonged symptomatic recovery from infection with Covid-19 (“long hauler syndrome” or PASC, for post-acute sequelae of Covid-19) represents a severe form of CFS/ME and thus may also be amenable to personalized medicine with specific medications.