• Clonazepam: .5mg to 2mg combined with doxepin one half 10mg capsule up to 20mg at night. This combination is well tolerated by CFIDS patients.

• Topographic Brain Mapping (TBM) and Neurotherapy.

Dr. Cheney found 95 percent of 1,200 CFIDS patients had abnormal TBM's. TBM is a specialized EEG that can demonstrate subtle asymmetries, lateralization, and localization effects more efficiently than a standard EEG.

Neurophychophysiologist Dr. Myra Preston discovered what she believes is a sensitive and specific marker for CFIDS using the TBM, which is a predominance of delta waves and theta waves in cognitively challenged CFIDS patients, and lack of appropriate shifting to higher frequencies. Through neurotherapy (her method is patented) she trains patients to increase the frequency of their brain waves, which seems to improve cognitive functioning and other symptoms. More study is needed.

Dr. Susan Abbey, Toronto psychiatrist: According to Dr. Abbey, "Helping CFS patients learn new coping skills is the most successful treatment. Cognitive behaviourial therapy is the most promising and effective rehabilitation model. It breaks the vicious cycle of learned dependency and helplessness."

Cognitive therapy aims to change habitual and repetitive thought patterns that produce habitual and repetitive emotional reactions. Founded by psychiatrist Dr. Albert Ellis, one of the basic premises is that feelings are determined by thought patterns and not by events. Highly recommended are two books by Dr. David Burns, FEELING GOOD AGAIN: THE NEW MOOD THERAPY, and the FEELING GOOD AGAIN HANDBOOK.

Dr. Majid Ali: Associate Professor of Pathology at Columbia University in New York. Dr. Ali believes that CFS is the result of accelerated oxidative injury at the cellular level triggered by infectious and chemical agents. He has treated thousands of chronic fatigue patients using a comprehensive program involving detecting and treating food and environmental allergies, oral and intravenous supplements, restoring the normal ecology of the gut, and reducing load of toxic chemicals and heavy metals. In addition, he teaches patients autogenic training for stress management, and a special form of daily and slow sustained exercise. He claims that intravenous vitamin protocols substantially speed recovery time. He stresses that he is not using nutrients to correct vitamin deficiencies, but rather to correct redox dysregulations that occur in the body as a result of oxidative injuries to enzyme systems, and to avoid the use of drugs, to which these patients are often overly sensitive, and which further damage their weakened immune systems.

Dr. Alison Bested: A hematological pathologist, Dr. Bested has seen a large number of chronic fatigue patients in her Toronto practice. Dr. Bested believes that CFIDS has a multifactorial etiology including overuse of antibiotics and steroids; infectious agents (viral, bacterial, fungal, parasitic); physical trauma of surgery or auto accidents; genetic predisposition and major psychological traumas or stressful life events. Dr. Bested also emphasizes treating co-existing problems as well, such as chronic urinary infections, chronic sinusitis, inflammatory bowel disease and interstitial cystitis.

In addition, she has found that some patients demonstrate an overgrowth of candida and parasites in their fresh stool samples and subsequent cultures, which she then treats with the appropriate oral medications. The overgrowth of candida and parasites reflect an altered immune status.

Other pointers offered by Dr. Bested includes:

• Attention to diet especially eliminating sugar, lowering fat and increasing fibre.

• Progressive exercise program, regular rest periods and pacing throughout the day. She tells patients the story of the bricklayers. One group of healthy young brick layers worked full steam without any breaks. They lasted for only six hours. The second group worked forty-five minutes at a time with fifteen minute breaks, and were able to last for ten hours.

• Rest means lying down and shutting your eyes with no music, no TV and no distractions.

• The single most important thing for GP's, she feels, is to ensure that the patient has a good night's sleep. After trying tryptophan, she uses 10mg to 25mg of amitriptyline at bedtime for muscle aches and pain and insomnia. If this is not enough, she adds Cheney's clonazepam-doxepin combination above with good success.