Chronic Fatigue Syndrome and ADHD: What's the Link?

Medication intended for ADHD may help with cognitive issues.

Researchers exploring a possible link between chronic fatigue syndrome (ME/CFS) and attention deficit/hyperactivity disorder (ADHD) say fatigue may be an important symptom of adult ADHD, and that people with ME/CFS or other types of persistent fatigue should be looked at for ADHD. 

Early Research into an ADHD/Chronic Fatigue Link

In 2007, a study looked at a possible connection between ADHD (inattentive type), chronic fatigue syndrome, and fibromyalgia.

According to the abstract:

In an outpatient psychiatric clinic, a number of adult patients who presented primarily with symptoms of ADHD, predominately inattentive type, also reported unexplained fatigue, widespread musculoskeletal pain or a pre-existing diagnosis of CFS or FMS. As expected, ADHD pharmacotherapy usually [improved] the core ADHD symptoms of inattention, distractibility, hyperactivity, and impulsivity. Less expected was the observation that some patients also reported [improvement] of pain and fatigue symptoms.

This finding led to increased interest in the use of ADHD medications -- such as Ritalin -- to relieve some of the cognitive challenges related to chronic fatigue.

2013 Study Supports Findings

Their new study looked at three cases of ME/CFS in people who'd responded poorly to treatment. Researchers found that all three met the criteria for ADHD, and all three responded well to psychostimulant medications, which are a common part of ADHD treatment.

They say the patients saw improvements in fatigue, pain, cognitive dysfunction and other symptoms. According to their abstract:

...all patients were found to meet criteria for attention-deficit/hyperactivity disorder (ADHD) and underwent a standard regimen of a psychostimulant medication. After treatment with psychostimulants, the 3 patients reported improved symptoms of fatigue and pain, and cognitive and core ADHD symptoms.

Researchers concluded that ADHD and ME/CFS may share a common underlying mechanism and that over time, ADHD may develop into chronic fatigue syndrome and pain. (It's unclear whether this would most appropriately be considered a new form of ADHD or a subset of ME/CFS.)

From previous research, we know that ME/CFS and ADHD both involve neurotransmitter dysregulation that may involve serotonin, norepinephrine and dopamine. However, that alone isn't enough to say they're related - neurotransmitters perform different jobs in different regions, and different jobs within a region based on specific receptors, so it's a complicated matter.

Should You Consider Ritalin for Your Chronic Fatigue Symptoms?

While research does suggest a connection, ADHD pharmaceuticals are not typically prescribed for chronic fatigue. Some doctors do prescribe ADHD medications off-label for ME/CFS, and they work for some (but not all) people. If you are experiencing difficulty with staying focused and attentive, you may want to bring this research to your doctor's attention.



University of Maryland Medical Center. Chronic fatigue syndrome. Website.

Young, JL. Chronic fatigue syndrome: 3 cases and a discussion of the natural history of attention-deficit/hyperactivity disorder. Postgrad Med. 2013 Jan;125(1):162-8. 

Young, JL et al. Fibromylagia, chronic fatigue, and adult attention deficit hyperactivity disorder in the adult: a case study. Psychopharmacol Bull. 2007;40(1):118-26.

Continue Reading