Wiebe, E · Canadian family physician Medecin de famille canadien · 1996
This study looked at two individual ME/CFS patients to see which treatments might help them personally. One patient tried high-dose vitamin B12 injections but they didn't help. Another patient tried a medication called nimodipine and found it worked very well for them. The doctors used a special testing method called N of 1 trials, where treatments are tested in one person at a time to see what actually helps that specific individual.
This study highlights the potential value of personalized treatment testing in ME/CFS, where heterogeneity means patients respond differently to interventions. It suggests that N of 1 trial methodology could be a useful clinical tool for physicians managing individual ME/CFS patients who need to identify which specific treatments work for them.
This study does NOT prove that vitamin B12 is ineffective for all ME/CFS patients or that nimodipine is a general cure—these were only two individual cases. The findings cannot be applied broadly to the ME/CFS population, and single-case responses do not establish causation or provide evidence of efficacy beyond the individuals studied. Placebo effects and natural symptom fluctuation are not controlled for.
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
Wiebe, E (1996). N of 1 trials. Managing patients with chronic fatigue syndrome: two case reports.. Canadian family physician Medecin de famille canadien. https://pubmed.ncbi.nlm.nih.gov/8939323/
BibTeX
@article{mecfsatlas-wiebe-1996-trials-managing,
author = {Wiebe, E},
title = {N of 1 trials. Managing patients with chronic fatigue syndrome: two case reports.},
journal = {Canadian family physician Medecin de famille canadien},
year = {1996},
note = {PubMed: 8939323},
url = {https://www.mecfsatlas.com/evidence/wiebe-1996-trials-managing},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-29. https://www.mecfsatlas.com/evidence/wiebe-1996-trials-managing
Contribute
Private, reviewed by a human. Not a public comment thread.