TRI-ME: Trimetazidine to treat Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: A double-blind, randomised, placebo-controlled efficacy trial

Myalgic Encephalomyelitis / Chronic Fatigue Syndrome (ME/CFS) is a serious, long-term illness causing profound fatigue that is made worse by activity, unrefreshing sleep, cognitive difficulties (brain fog), and post-exertional malaise. Despite affecting hundreds of thousands of Australians, ME/CFS has no approved treatments, and current management is largely focused on symptom management rather than addressing the underlying biology of the condition. This study is trialling trimetazidine — an existing medication approved in Europe and Asia for treating angina (heart pain) — as a potential treatment for ME/CFS. Trimetazidine works by improving how the mitochondria (the 'energy factories' of cells) produce energy, and has anti-inflammatory and antioxidant properties. Participants will take either trimetazidine or a placebo twice daily for 12 weeks and be assessed for changes in fatigue, function, and quality of life. You may be eligible if you are aged 18 or older, meet the Canadian Consensus Criteria for ME/CFS diagnosis, have a current treating physician, and are willing and able to give informed consent. People with severe kidney disease, Parkinson's disease, restless legs syndrome, current major psychiatric disorders, pregnancy, or who are currently enrolled in another clinical trial would not be eligible.