Psychiatrist Joel Young M.D. author of Understanding and Treating Chronic Fatigue: A Practical Guide for Patients and Practitioners.
Joel L. Young, M.D.

Psychiatrist pens book that suggests ADHD medications.

Many people pre-coronavirus pandemic were used to going at a nonstop pace, bustling to and from work and/or school, getting involved in religious and social activities as well as jumping the daily hurdles that life inevitably throws a person’s way.

Some people, however, have a very difficult time dealing with everyday stress, often finding it challenging to get out of bed. Not only do they live with unrelenting fatigue not ameliorated by 10-12 hours of sleep, they feel emotionally overwhelmed and deal with brain fog. They also may have physical pain that could be linked to fibromyalgia, temporomandibular joint dysfunction (TMJ) and migraine.

Joel L. Young, M.D., founder and director of the Rochester Center for Behavioral Medicine, who has done studies in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS), has a message for these individuals:

“To patients with ME/CFS, I know you’re out there, and I know you need help,” he said. “We get how much you suffer. You deserve better than what you’ve gotten.”

Young, who has conducted research into Chronic Fatigue Syndrome for approximately 30 years, has recently published a book titled Understanding and Treating Chronic Fatigue: A Practical Guide for Patients and Practitioners. The book was published by Praeger Press and sells for $39. It is available in hardcover and in electronic book format on Amazon and from Praeger.

 Understanding and Treating Chronic Fatigue: A Practical Guide for Patients and Practitioners, by Psychiatrist Joel L. Young M.D.

Young, a member of Temple Israel, said the term Chronic Fatigue Syndrome was established in the 1990s and is considered an “orphan disease” since no medical specialties have claimed ownership in treating the condition. People of any age can develop CFS, although the age range is typically people in their 30s to 50s. Women are more commonly diagnosed with the syndrome than men.

“Often patients with ME/CFS feel a bit abandoned or diminished or marginalized,” he said. “Here’s where I get involved. I’ve been interested in ADHD and have been the principal investigator in over 100 clinical trials. I recognize that some of the medicines that we use to treat ADHD specifically addressed many of the symptoms of ME/CFS.”

Link to ADHD?

Young has developed the hypothesis that many of the people who have symptoms of ME/CFS may have what could be considered “ADHD inattentive type” as they get older. Essentially, their ADHD symptoms have manifested themselves as fatigue, he said.

Building on that concept, Young obtained independent funding and published a study in 2012 in the journal Psychiatry Research about the effects of LDX (lisdexamphentamine) — also known commercially as Vyvanse — on those with ME/CFS. Vyvanse has been approved by the FDA to treat ADHD as well as binge-eating disorder, although not specifically for ME/CFS.

“We found that patients with ME/CFS who were treated with LDX have far less fatigue and pain than those treated with placebo,” he said. “That was published in the academic journal. The book was a way of connecting more to patients with their problem. I hope my book will spur more studies. Good ideas have to be met with skepticism, and they have to be replicated … with multi-site studies.”

Young said he will also open a new clinical trial sometime in the fall, hopefully recruiting 50 patients to test the efficacy of the drug Sunosi (solriamfetol), which is prescribed for excessive daytime sleepiness due to obstructive sleep apnea or narcolepsy.

Longstanding Fatigue

He also said there’s increasing evidence that there’s a post-COVID syndrome with symptoms that include fatigue and low energy but that the science to trace that is developing. In general though, symptoms of CFS have to be longstanding (six months or more) and cause functional impairment. Often, those with ME/CFS are prescribed anti-depressants though those medications often don’t solve the entire problem, Young said.

One of Young’s longtime patients, Jane (not her real name), said she was referred to Young about 20 years ago after working with a social worker for severe anxiety and depression. Jane had noticed difficulty in concentration and not being able to filter out noise in large crowds. She said she was also having a very hard time waking in the morning and finding energy to tackle the day, considering she was helping her father with dementia get his affairs in order.

The woman who in the past has volunteered with several Jewish organizations, said she learned she had a diagnosis of ADHD, with moderate symptoms in addition to chronic fatigue syndrome.

“I was overwhelmed, and my energy level came in spurts,” she said. “I felt like I was having a breakdown.”

Jane was prescribed Zoloft for her depression and Adderall XR, which is a common prescription for ADHD. She has found great help with the medications in terms of focusing, recall and managing her emotions.

“Family members close to me noticed the stabilizing effect,” she said. “It was explained to me that it was like putting a shield on your emotions” so that negative emotions don’t become overwhelming.

“The medication filters and focuses you. I’ve always taken [the Adderall] when I’m working,” she said.

Although she’s found living in the pandemic world challenging, Jane finds joy in singing and has been taking online programming and classes through the Jewish Federation’s JLearn program.

“They have been wonderful in getting you through and feeling productive,” she said. She encourages those who feel overwhelmed with fatigue and negative emotions to ask for help until all symptoms are under control.

“Try not to tough it out yourself,” she said. “Once I got stable on the antidepressants and my mood, I realized there was still a problem” with focus and fatigue.

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