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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 6,166 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 →

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214 studies

E0 — Consensus643E1 — Replicated320E2 — Moderate2,781E3 — Preliminary2,422

ME/CFS4,025Long COVID216Post-infectious189Overlapping1,050

Required for diagnosis414Not specified / unclear2,218Not required3,534

Post-Exertional Malaise1,063Cognitive Dysfunction1,735Pain1,620Unrefreshing Sleep799Orthostatic Intolerance478

Cytokines818Gene Expression567Metabolomics473Neuroimaging468Autoantibodies458

Infection-Triggered1,174Long COVID Overlap587Pediatric493Severe231

Strong Phenotyping438Sex-Stratified326Severe ME Included118

Systematic Review265Meta-Analysis60RCT300

Peer-reviewed6,109Preprint3Unclear54

81–100 of 214 studies

E1 ReplicatedTrialPEM not requiredRCT

Cognitive behavioural therapy in chronic fatigue syndrome: a randomised controlled trial of an outpatient group programme.

O'Dowd, H, Gladwell, P, Rogers, C A et al.·Health technology assessment (Winchester, England)·2006

This study compared three approaches for managing ME/CFS: group cognitive behavioural therapy (CBT), education and support groups, and standard medical care. After 12 months, patients who received CBT showed improvements in mental health, fatigue levels, and walking ability compared to standard care, though improvements were modest and many patients did not fully recover.

E1 ReplicatedTrialPEM not requiredRCT

The therapeutic effects of electrical acupuncture and auricular-plaster in 32 cases of chronic fatigue syndrome.

Yuemei, Li, Hongping, Liu, Shulan, Feng et al.·Journal of traditional Chinese medicine = Chung i tsa chih ying wen pan·2006

This study tested whether electrical acupuncture combined with auricular plaster (a small patch placed on the ear) could help people with chronic fatigue syndrome. The treatment group showed improvement in about 94% of cases, compared to 75% in the group taking a standard medicine (hydrocortisone). The results suggest this traditional Chinese medicine approach may work better than the medication tested.

E1 ReplicatedTrialPEM not requiredRCT

Effect of ondansetron, a 5-HT3 receptor antagonist, on fatigue in chronic hepatitis C: a randomised, double blind, placebo controlled study.

Piche, T, Vanbiervliet, G, Cherikh, F et al.·Gut·2005

This study tested whether a medication called ondansetron, which affects serotonin in the brain, could reduce fatigue in people with chronic hepatitis C. Thirty-six patients took either ondansetron or a placebo pill for one month and were then observed for another month. Ondansetron significantly improved fatigue scores by more than 30% within two weeks and maintained this improvement, while placebo did not.

E1 ReplicatedTrialPEM unclearRCT

Acupuncture and Chinese patent drugs for treatment of chronic fatigue syndrome.

Lijue, Zhao·Journal of traditional Chinese medicine = Chung i tsa chih ying wen pan·2005

This study tested whether acupuncture and traditional Chinese herbal medicines could help people with chronic fatigue syndrome (ME/CFS). Researchers compared patients who received these treatments to a control group to see if they experienced improvements in their fatigue and symptoms.

E1 ReplicatedTrialPEM not requiredRCT

Effect of psychiatric disorders on outcome of cognitive-behavioural therapy for chronic fatigue syndrome.

Prins, Judith, Bleijenberg, Gijs, Rouweler, Eufride Klein et al.·The British journal of psychiatry : the journal of mental science·2005

This study looked at whether having a mental health condition (like depression or anxiety) affects how well cognitive-behavioural therapy (CBT) works for ME/CFS. Researchers interviewed 270 people with ME/CFS about their psychiatric history and tracked their recovery after CBT treatment. Surprisingly, they found that people with mental health diagnoses improved just as much as those without them, suggesting that having a psychiatric condition doesn't prevent CBT from helping with ME/CFS symptoms.

E1 ReplicatedTrialPEM not requiredObservational

Predictors of outcome following treatment for chronic fatigue.

Darbishire, Lucy, Seed, Paul, Ridsdale, Leone·The British journal of psychiatry : the journal of mental science·2005

This study looked at 105 people with fatigue who received either exercise therapy or talking therapy to see which patients improved and which didn't. The researchers found that having a formal diagnosis of chronic fatigue syndrome made it much less likely that people would improve with these treatments. The effect was even stronger if patients had severe limitations in daily activities or believed their illness would have serious consequences.

E1 ReplicatedTrialPEM not requiredRCT

Cognitive behaviour therapy for adolescents with chronic fatigue syndrome: randomised controlled trial.

Stulemeijer, Maja, de Jong, Lieke W A M, Fiselier, Theo J W et al.·BMJ (Clinical research ed.)·2005

This study tested whether cognitive behaviour therapy (CBT)—a type of talking therapy that helps people change unhelpful thinking patterns and gradually return to activities—could help teenagers with ME/CFS. Teenagers who received 10 sessions of CBT over five months showed greater improvements in fatigue, ability to do daily activities, and school attendance compared to those who waited for treatment. The therapy was tailored based on whether teenagers were mostly active or inactive.

E1 ReplicatedTrialPEM not requiredRCT

Cost-effectiveness of cognitive behaviour therapy for patients with chronic fatigue syndrome.

Severens, J L, Prins, J B, van der Wilt, G J et al.·QJM : monthly journal of the Association of Physicians·2004

This study compared the cost and effectiveness of cognitive behaviour therapy (CBT), support groups, and usual care for ME/CFS patients over 14 months. CBT helped more patients improve (27% at 14 months) compared to support groups (11%) and usual care (20%), and was less expensive than support groups. However, compared to doing nothing special, CBT cost about €20,500 per patient who showed meaningful improvement.

E1 ReplicatedTrialPEM not requiredRCT

Efficacy of cognitive-behavioural therapy by general practitioners for unexplained fatigue among employees: Randomised controlled trial.

Huibers, Marcus J H, Beurskens, Anna J H M, Van Schayck, Constant P et al.·The British journal of psychiatry : the journal of mental science·2004

This study tested whether a short course of talking therapy (cognitive-behavioural therapy) delivered by general doctors could help employees with persistent, unexplained fatigue who were on sick leave. Over one year, patients who received 5-7 sessions of this therapy showed no greater improvement in fatigue, work absences, or recovery than those who received no treatment. The therapy did not prove helpful for this type of fatigue.

E1 ReplicatedTrialPEM not requiredRCT

Effect of galantamine hydrobromide in chronic fatigue syndrome: a randomized controlled trial.

Blacker, C V Russell, Greenwood, David T, Wesnes, Keith A et al.·JAMA·2004

Researchers tested whether a medication called galantamine hydrobromide could help people with ME/CFS by comparing it to a placebo (dummy pill) in 434 patients across multiple countries. After 16 weeks of treatment, the medication did not work better than placebo for relieving fatigue, sleep problems, pain, or overall quality of life. This study shows that galantamine is not an effective treatment for ME/CFS.

E1 ReplicatedTrialPEM not requiredRCT

Biofeedback-based psychophysiological treatment in a primary care setting: an initial feasibility study.

Ryan, Meredith, Gevirtz, Richard·Applied psychophysiology and biofeedback·2004

This study tested whether biofeedback—a technique that helps people become aware of and control their body's responses—could help patients with chronic fatigue syndrome and similar conditions in a regular doctor's office. Nineteen patients received biofeedback treatment while 30 others received usual care. Patients who completed the biofeedback treatment reported fewer and less severe symptoms, and the group also had lower medical costs after treatment.

E1 ReplicatedTrialPEM not requiredRCT

Quality of life and symptom severity for individuals with chronic fatigue syndrome: findings from a randomized clinical trial.

Taylor, Renée R·The American journal of occupational therapy : official publication of the American Occupational Therapy Association·2004

This study tested whether a rehabilitation program designed with input from ME/CFS patients could help people feel better and reduce their symptoms. Forty-seven people with ME/CFS were split into two groups—one started the program right away while the other waited. Researchers measured symptom severity and quality of life before, during, and after the program. The group that received the program showed meaningful improvements in both how severe their symptoms felt and their overall quality of life compared to the group that waited.

E1 ReplicatedTrialPEM not requiredRCT

Randomized controlled trial of Siberian ginseng for chronic fatigue.

Hartz, A J, Bentler, S, Noyes, R et al.·Psychological medicine·2004

This study tested whether Siberian ginseng could reduce fatigue in people with chronic fatigue lasting at least 6 months. Ninety-six people took either Siberian ginseng or a placebo pill for 2 months. While both groups improved during the study, the ginseng did not work better than placebo overall, though it showed some promise in people with moderate (not severe) fatigue.

E1 ReplicatedTrialPEM not requiredRCT

Comparison of oral nicotinamide adenine dinucleotide (NADH) versus conventional therapy for chronic fatigue syndrome.

Santaella, María L, Font, Ivonne, Disdier, Orville M·Puerto Rico health sciences journal·2004

This study tested whether a supplement called NADH could help people with ME/CFS feel better compared to standard nutritional supplements and counseling. Over 24 months, 12 patients received NADH while a comparison group received conventional treatment. During the first three months, patients taking NADH showed significant improvement in their symptoms, but by later time points, both groups improved at similar rates.

E1 ReplicatedTrialPEM not requiredRCT

L-carnitine decreases severity and type of fatigue induced by interferon-alpha in the treatment of patients with hepatitis C.

Neri, Sergio, Pistone, Giovanni, Saraceno, Barbara et al.·Neuropsychobiology·2003

This study tested whether a supplement called L-carnitine could reduce fatigue caused by interferon-alpha treatment in people with hepatitis C. Fifty patients received either interferon alone or interferon plus L-carnitine daily. Patients taking the supplement experienced significantly less physical and mental fatigue, and their fatigue was less severe, particularly in the first three months of treatment.

E1 ReplicatedTrialPEM not requiredProtocol

Efficacy of distant healing--a proposal for a four-armed randomized study (EUHEALS).

Walach, H, Bösch, H, Haraldsson, E et al.·Forschende Komplementarmedizin und klassische Naturheilkunde = Research in complementary and natural classical medicine·2002

This study tested whether distant healing—treatment from healers who don't meet you in person but work with your name and photo—might help people with ME/CFS and related conditions. Researchers randomly assigned 400 patients to receive healing, no healing, or healing without knowing about it, to see if the treatment itself works or if belief in it creates the benefit. They measured mental health over 6 months to see if distant healing made a difference.

E1 ReplicatedTrialPEM not requiredLongitudinal

Long-term outcome of cognitive behavior therapy versus relaxation therapy for chronic fatigue syndrome: a 5-year follow-up study.

Deale, A, Husain, K, Chalder, T et al.·The American journal of psychiatry·2001

Researchers compared two types of therapy for ME/CFS: cognitive behavior therapy (CBT, which focuses on changing thought patterns and gradually increasing activity) and relaxation therapy. After 5 years, 68% of people who received CBT reported feeling much or very much improved, compared to 36% who received relaxation therapy. However, neither therapy fully eliminated fatigue symptoms, and some patients found it hard to keep improving after their regular treatment ended.

E1 ReplicatedTrialPEM not requiredRCT

Cognitive behaviour therapy for chronic fatigue syndrome: a multicentre randomised controlled trial.

Prins, J B, Bleijenberg, G, Bazelmans, E et al.·Lancet (London, England)·2001

This study tested whether cognitive behaviour therapy (CBT)—a type of talking therapy that focuses on thoughts and behaviours—helps people with ME/CFS. Researchers compared CBT with support groups and no treatment across three hospitals, following 278 patients for 14 months. CBT showed modest benefits for fatigue and daily functioning compared to the other groups, though only about one-third to one-half of patients experienced meaningful improvement.

E1 ReplicatedTrialPEM not requiredRCT

A randomized, double-blind placebo-controlled trial of moclobemide in patients with chronic fatigue syndrome.

Hickie, I B, Wilson, A J, Wright, J M et al.·The Journal of clinical psychiatry·2000

This study tested whether a medication called moclobemide could help people with ME/CFS. Ninety patients received either moclobemide or a placebo for several weeks. About half of those taking moclobemide felt better, compared to one-third taking placebo—mainly reporting more energy and vigor rather than improvement in mood. The medication appeared to work best for people who also had immune system problems.

E1 ReplicatedTrialPEM not requiredRCT

Illness beliefs and treatment outcome in chronic fatigue syndrome.

Deale, A, Chalder, T, Wessely, S·Journal of psychosomatic research·1998

This study examined whether what ME/CFS patients believe about the cause of their illness affects how well they recover with treatment. Researchers found that patients' beliefs about whether their condition was physical didn't predict treatment success. However, patients who changed their views about avoiding exercise and activity—and actually started doing more—improved more with cognitive-behavior therapy than with relaxation alone.

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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.