Blondel-Hill, E, Shafran, S D · Drugs · 1993 · DOI
This 1993 guide explains that ME/CFS is a real illness defined by severe, disabling fatigue along with other physical and mental symptoms, though its exact cause remains unknown. The main treatment is getting a proper diagnosis, learning about the condition, and working with a caring doctor who understands it. Some patients may benefit from antidepressant medications even without depression, though no single treatment has been proven to work reliably for everyone.
This guideline addresses a critical gap in CFS management by emphasizing diagnostic clarity and the therapeutic value of empathetic clinical engagement in reducing unnecessary investigation and specialist referrals. It highlights that despite decades of research, no single disease mechanism explains CFS and no proven pharmacological cure exists, underscoring the need for individualized symptom-based approaches.
This review does not establish the underlying biological cause of ME/CFS, nor does it prove that antidepressants or any other specific medication is effective for the majority of patients. The guideline acknowledges that most proposed treatments lack robust double-blind, placebo-controlled evidence and cannot be recommended as established therapies.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
The first block is for the primary paper and is the citation you should use in research work. The atlas-snapshot line only applies if you are specifically referring to this atlas’s reading of the paper on the date shown.
Primary citation
Blondel-Hill, E & Shafran, S D (1993). Treatment of the chronic fatigue syndrome. A review and practical guide.. Drugs. https://doi.org/10.2165/00003495-199346040-00005
BibTeX
@article{mecfsatlas-blondel-hill-1993-treatment-chronic,
author = {Blondel-Hill, E and Shafran, S D},
title = {Treatment of the chronic fatigue syndrome. A review and practical guide.},
journal = {Drugs},
year = {1993},
doi = {10.2165/00003495-199346040-00005},
note = {PubMed: 7506650},
url = {https://www.mecfsatlas.com/evidence/blondel-hill-1993-treatment-chronic},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-30. https://www.mecfsatlas.com/evidence/blondel-hill-1993-treatment-chronic
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