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ME/CFS Atlas — A public knowledge atlas for ME/CFS

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ME/CFS Atlas is an evidence reference platform, not a medical provider. Content is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.

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ME/CFS Evidence Browser — Classified Studies on Myalgic Encephalomyelitis

Evidence browser

Search and filter 6,205 studies by evidence level, diagnostic criteria, PEM status, and research domain. Each entry links to the original source.

Studies sorted by evidence level, then year. Browse by topic instead →

Evidence level (E0–E3) reflects study type and replication, not methodological quality. A weak systematic review still sits at E0. How evidence levels work →

Sort

220 studies

E0 — Consensus654E1 — Replicated321E2 — Moderate2,807E3 — Preliminary2,423

ME/CFS4,040Long COVID224Post-infectious190Overlapping1,064

Required for diagnosis417Not specified / unclear2,251Not required3,537

Post-Exertional Malaise1,082Cognitive Dysfunction1,749Pain1,628Unrefreshing Sleep805Orthostatic Intolerance484

Cytokines821Gene Expression573Metabolomics477Neuroimaging472Autoantibodies460

Infection-Triggered1,182Long COVID Overlap604Pediatric496Severe232

Strong Phenotyping445Sex-Stratified330Severe ME Included119

Systematic Review272Meta-Analysis61RCT301

Peer-reviewed6,148Preprint3Unclear54

201–220 of 220 studies

E3 PreliminaryReviewPEM unclearReview-Narrative

The symptoms and management of myalgic encephalomyelitis.

Richardson, Amanda·Nursing times·2002

ME/CFS is a long-lasting illness that affects people differently, and doctors still don't fully understand what causes it or how to cure it. However, there are helpful ways to manage the symptoms, and the best treatment plans are created together with each individual patient. While no medicine has been specifically designed for ME/CFS, doctors can adapt treatments used for similar symptoms in other conditions to help reduce suffering.

E3 PreliminaryReviewPEM unclearReview-Narrative

Chronic fatigue syndrome. Symptom relief is primary goal.

Hoffman, Diane B·Advance for nurse practitioners·2002

This article discusses chronic fatigue syndrome (ME/CFS) and emphasizes that helping patients feel better is the main goal of treatment. The author, writing for nurse practitioners, focuses on practical approaches to managing symptoms and improving patients' quality of life.

E3 PreliminaryCohortPEM not requiredObservational

Treatment of chronic fatigue syndrome with 5-HT3 receptor antagonists--preliminary results.

Späth, M, Welzel, D, Färber, L·Scandinavian journal of rheumatology. Supplement·2000

Researchers tested whether two medications that block serotonin receptors (tropisetron and ondansetron) might help ME/CFS patients feel less fatigued. About one third of the patients who took these medications reported meaningful improvement in fatigue and energy levels over 15 days, with no serious side effects reported.

E3 PreliminaryReviewPEM unclearReview-Narrative

[Physical activity for mental health].

Martinsen, E W·Tidsskrift for den Norske laegeforening : tidsskrift for praktisk medicin, ny raekke·2000

This review examined whether exercise can help treat mental health conditions like depression and anxiety. The research found that exercise works best for mild to moderate depression and chronic fatigue syndrome, and may also help with panic disorder, anxiety, and other conditions. Exercise appears to be a useful, affordable alternative or addition to standard treatments like medication and therapy.

E3 PreliminaryPEM not required

Fatigue that doesn't go away.

Propsner, N M·New Jersey medicine : the journal of the Medical Society of New Jersey·1999

This article describes chronic fatigue syndrome (ME/CFS), a condition where people experience extreme tiredness that doesn't improve with rest. The fatigue often begins after a viral infection and is more commonly seen in middle-aged women. While current treatments can help manage symptoms, researchers are working to better understand the condition and develop more effective approaches.

E3 PreliminaryReviewPEM unclearReview-Narrative

Chronic fatigue syndrome: current concepts of pathogenesis and treatment.

Lloyd, A R, Hickie, I, Peterson, P K·Current clinical topics in infectious diseases·1999

This review article examines what scientists understood in 1999 about how ME/CFS develops and what treatments might help. The authors synthesize existing knowledge about the condition's causes, which involve the immune system, infections, and other body system changes. They discuss various approaches to managing symptoms and improving function for people living with ME/CFS.

E3 PreliminaryBehavioralPEM unclear

A 56-year-old woman with chronic fatigue syndrome, 1 year later.

Delbanco, T L, Daley, J, Hartman, E E·JAMA·1998

This study describes the medical journey of one woman with ME/CFS over the course of a year, documenting how her symptoms changed and how different treatments affected her condition. The researchers tracked her experiences to provide insight into what living with ME/CFS is like over time and what approaches doctors tried to help her.

E3 PreliminaryReviewPEM not requiredReview-Narrative

Chronic fatigue syndrome: an update for clinicians in primary care.

Houde, S C, Kampfe-Leacher, R·The Nurse practitioner·1997

This article explains what ME/CFS is and how doctors can recognize it. The main challenge is that ME/CFS doesn't show up on standard tests, so doctors need to rule out other conditions first. Treatment works best when it's tailored to each person's specific symptoms and needs.

InterventionsDiagnostics

E3 PreliminaryBehavioralPEM unclear

Hypnosis in chronic fatigue syndrome.

Gregg, V H·Journal of the Royal Society of Medicine·1997

This study examined whether hypnosis might help people with ME/CFS. Researchers compared people with ME/CFS who received hypnosis treatment to those who did not. The study provides early information about whether this type of mind-body treatment might be beneficial for managing symptoms.

E3 PreliminaryCohortPEM not requiredCase-Control

N of 1 trials. Managing patients with chronic fatigue syndrome: two case reports.

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.

E3 PreliminaryReviewPEM not requiredReview-Narrative

[Chronic fatigue syndrome].

Rouillon, F, Delhommeau, L, Vinceneux, P·Presse medicale (Paris, France : 1983)·1996

This review examines chronic fatigue syndrome (CFS), a condition where people experience lasting, unexplained tiredness that interferes with daily life. The condition has been recognized for over a century under different names. Currently, doctors and researchers don't fully understand what causes CFS, though it may involve viral infections, immune system problems, or psychiatric factors. Most treatments tested so far have shown limited effectiveness.

E3 PreliminaryGuidelinePEM unclearGuideline

[Therapeutic guidelines in chronic fatigue syndrome].

Bertolín Guillén, J M, Bedate Villar, J·Actas luso-espanolas de neurologia, psiquiatria y ciencias afines·1994

This article reviews different treatment approaches for ME/CFS, which currently lacks a definitive cure. Researchers found that antidepressant medications—particularly amfebutamone and selective serotonin reuptake inhibitors—showed the most promise, while other medications (antivirals, immune boosters, anti-inflammatory drugs) had limited success. A combination of cognitive behavioral therapy and comprehensive psychiatric management tailored to each patient's needs also appeared helpful.

E3 PreliminaryReviewPEM not requiredReview-Narrative

Amma therapy: a holistic approach to chronic fatigue syndrome.

Young, A·Journal of holistic nursing : official journal of the American Holistic Nurses' Association·1993

This study looked at Amma Therapy, a hands-on healing practice, as a possible way to help people with ME/CFS who feel frustrated with traditional medical care. The researcher examined how this holistic approach might benefit patients with chronic fatigue. The study suggests that some people with ME/CFS may find relief through this alternative therapy.

E3 PreliminaryCohortPEM not requiredCase-Control

Chronic fatigue syndrome.

Gerow, G, Poierier, M B, Alt, R·Journal of manipulative and physiological therapeutics·1992

This study describes a 36-year-old woman who came to her doctor with severe fatigue and symptoms that looked like an immune system problem, but was eventually diagnosed with ME/CFS instead. The doctors used specific criteria to confirm the diagnosis. The patient reported feeling somewhat better after receiving chiropractic treatment, though this was only one person's experience.

E3 PreliminaryMechanismPEM not requiredObservational

Bupropion treatment of fluoxetine-resistant chronic fatigue syndrome.

Goodnick, P J, Sandoval, R, Brickman, A et al.·Biological psychiatry·1992

This study tested whether bupropion, an antidepressant medication, could help ME/CFS patients who didn't benefit from or couldn't tolerate fluoxetine (another antidepressant). Nine patients took 300 mg of bupropion daily for 8 weeks and showed significant improvement in depression symptoms. The researchers also found that bupropion appeared to affect certain brain chemicals and immune markers in ways that correlated with symptom improvement.

E3 PreliminaryCohortPEM not requiredObservational

Chronic Fatigue Syndrome: Do herbs or homeopathy help?

Leyton, E, Pross, H·Canadian family physician Medecin de famille canadien·1992

This study tested whether herbal and homeopathic treatments could help six ME/CFS patients feel better. Researchers tracked symptoms and measured blood markers before and after treatment. The treatments did not produce any measurable improvements in symptoms or immune function.

E3 PreliminaryReviewPEM not requiredReview-Narrative

Chronic fatigue syndrome. Recent advances in diagnosis and treatment.

Bell, D S·Postgraduate medicine·1992

ME/CFS typically starts suddenly with severe tiredness and flu-like symptoms that come and go over months or years. While blood tests sometimes show immune system changes, doctors diagnose ME/CFS mainly by recognizing the pattern of symptoms and ruling out other illnesses. Current treatment focuses on managing symptoms and helping patients cope with this long-lasting, disabling condition.

InterventionsDiagnostics

E3 PreliminaryBehavioralPEM unclearCase-Control

Nortriptyline in chronic fatigue syndrome: a double blind, placebo-controlled single case study.

Gracious, B, Wisner, K L·Biological psychiatry·1991

This study tested whether a medication called nortriptyline (an older type of antidepressant) could help one person with ME/CFS. The researchers gave the patient either the medication or a placebo (inactive pill) without telling them which was which, and tracked how they felt. This type of single-patient study can provide useful information, but it only shows what happened with one individual and cannot prove the treatment works for everyone with ME/CFS.

E3 PreliminaryBehavioralPEM unclear

Effective treatment for an adolescent with chronic fatigue syndrome.

Wachsmuth, J R, MacMillan, H L·Clinical pediatrics·1991

This study describes the case of a teenager with chronic fatigue syndrome (ME/CFS) who received treatment. The doctors documented how the patient was evaluated and what approach was used to help manage their symptoms. This single case report provides an early clinical example of treating ME/CFS in young patients.

E3 PreliminaryBehavioralPEM not requiredObservational

Cognitive behaviour therapy in chronic fatigue syndrome.

Butler, S, Chalder, T, Ron, M et al.·Journal of neurology, neurosurgery, and psychiatry·1991

This study tested whether cognitive behaviour therapy (CBT)—a type of talk therapy focusing on thoughts and behaviors—could help 50 ME/CFS patients who had been sick for an average of five years. Patients received therapy aimed at identifying unhelpful beliefs about their symptoms and gradually returning to activities. The therapy led to meaningful improvements in fatigue, overall functioning, and mood, though some patients refused treatment.

Or browse by topic

PEM Immune Neuro Metabolic Biomarkers Severe ME Long COVID Cognitive

Curated Collections

Thematic groupings by clinical question or research area.

Neuroinflammation Evidence

PET imaging and other studies providing evidence for brain inflammation in ME/CFS.

Metabolism & Mitochondria

Metabolomics and mitochondrial function studies revealing energy metabolism disruption.

Biomarkers

Studies identifying potential biological markers for ME/CFS diagnosis and stratification.

PEM-Specific Research

Studies specifically examining post-exertional malaise, the hallmark symptom of ME/CFS.