I have found CNS stimulants to help, but I've never been an that high a dose, and not tried it systematically. Dr. Chia's comment was that something like ... just because I feel better on CNS Stimulants, doesn't mean I should use them to exercise. The thing is that drugs like these wear off overnight and so you know the PEM is still there when you wake up in the morning and feel that PEM cloud floating over you. It is just a mask, not a cure. Specifically, I responded to 10mg of Adderall. I currently don't take it. It is better just to not be on it long term until it is the last remating resort for treatment. It is hard to get and mostly a mask of symptoms -- which is fine if I eventually run out of other options.