I first read about the drug nimodipine (Nimotop) being used in very small dosages to treat chronic fatigue syndrome (ME/CFS) and related 'environmental', or 'invisible' illnesses (e.g. fibromyalgia, multiple chemical sensitivity) over a decade ago. Looking back I am not sure what prompted me to cast it aside so easily as a treatment option but this is what I did. I think perhaps I was more focused on resolving my gut dysbiosis issues which I saw (and still see) as the main driver of my ill-health. I also was more averse to opting for pharmaceutical interventions than I am now. Regardless, after reading of the recoveries of Dr. Mason-Brown MD and psychologist Dr. Kristina Downing-Orr in the latter's book Beating Chronic Fatigue using nimodopine as the basis, I have decided it is time to give it a shot.
In the intervening period since reading about nimodipine use in ME/CFS I have managed to overcome multiple chemical sensitivities (MCS) and learnt methods to manage what was crippling and life-threatening seasonal affective disorder (SAD). Unfortunately I have found myself going around in many circles and hitting many brick walls when it comes to tackling the ME/CFS from which I have suffered for 20+ years. All reasonable options are therefore on the table.
Before I discuss how nimodipine has been used by Mason-Brown, Downing-Orr and numerous others to successfully recover from ME/CFS, let's first take a look at the drug itself. It belongs to a class of drugs known as calcium channel blockers. Nimodipine was originally developed as a treatment for high blood pressure (hypertension) as it relaxes blood vessels and improves blood flow. However, since its effects are specific to blood flow in the brain it is now used mainly in cases of cerebral vasospasm and constriction (narrowing of blood vessels in the brain which reduces blood flow and oxygen supply). For this indication the typical dosage is 60mg every four hours.
Ok, so let's move on to how nimodipine is used to treat ME/CFS, fibromyalgia, MCS and other related conditions. The basic logic behind the use of the drug is simple: these illnesses involve reduced cerebral blood flow - as demonstrated by functional imaging scans of patients' brains (e.g. SPECT scans) - and a build up of toxins, both environmental and derived from dysfunctional metabolism. This situation results in dysfunction of control mechanisms in the brain and elsewhere, such as the limbic system, hypothalamus, and hypothalamic-pituitary-adrenal (HPA) axis. Since nimodipine increases cerebral blood flow it addresses the first issue directly, but crucially as a consequence proponents suggest, it helps to mobilize and remove accumulated neurotoxins. The herbal remedy Gingko biloba is used in combination to promote blood flow in the rest of the body and aid excretion of these neurotoxins.
As Downing-Orr describes in Beating Chronic Fatigue: "Once these neurotoxins are reduced and then flushed out, your brain will function much better, because blood flow to the important gland master controls (the HPA axis) will increase. As a result, the healing mechanisms should then be switched back on, allowing your body to start to recover."
The dosages for this nimodipine protocol for ME/CFS and other environmental illnesses is far lower than that used to treat primary cerebral vascular problems. Dr. Mason-Brown outlines an approach he used to heal himself and many patients subsequently that starts with 7.5mg daily and slowly builds up to a usual nominal dose of 30-40mg/day and an absolute maximum of 120mg/day, depending on individual circumstances and treatment response.
Since research over the past couple of decades has created a solid picture of both cerebral hypoperfusion (poor brain blood flow) and central homeostatic dysfunction (dysfunction of brain areas regulating systemic function), I believe the nimodipine treatment approach outlined by Downing-Orr and used successfully by pioneering physicians including Dr. Mason-Brown and Dr. Jay A. Goldstein is certainly worth considering. As such I plan to embark on the treatment in the coming months and will document my progress in the comments section below. I will also setup a dedicated group in the EiR Community. If anyone has any experience using nimodipine in this way or has any other comments or questions please don't hesitate to comment below!