Tag: antidepressants

Therapy of chronic fatigue syndrome

Abstract:

Chronic fatigue syndrome (CFS) is characterized by unexplained, debilitating fatigue or easy fatigability lasting longer than six months. While a number of clinical trials have been performed in CFS patients, there is currently no established therapy for CFS. Treatment with acyclovir of CFS patients is ineffective. Intravenous immunoglobulin therapy appears to be effective, though the results are controversial. Antidepressants might help the associated depression and anxiety but not other symptoms. Trials with magnesium have improved the well-being of patients. Restoration of NK activity by biological response modifiers, such as sizofirann, resulted in restoration of NK cell activity and recovery from CFS. Taken together, immunological abnormalities may be involved in CFS, and its restoration may produce clinical benefit in CFS.

 

Source: Uchida A. Therapy of chronic fatigue syndrome. Nihon Rinsho. 1992 Nov;50(11):2679-83.[Article in Japanese] http://www.ncbi.nlm.nih.gov/pubmed/1287242

 

Chronic fatigue syndrome

Comment on:

Antidepressant therapy in the chronic fatigue syndrome. [Br J Gen Pract. 1991]

General practitioners’ experience of the chronic fatigue syndrome. [Br J Gen Pract. 1991]

 

Sir, I read with interest the papers on the chronic fatigue syndrome (August Journal, p.324, 339). This syndrome has become an important diagnosis in both general practice and psychiatry. With the awareness of such a diagnostic entity, more patients are being recognized and managed (although the aetiology still remains unknown).

Depression as an inherent feature of chronic fatigue syndrome remains a controversial issue and great care is needed in treating these patients as ‘depressed’. Subjectively, many patients with the chronic fatigue syndrome describe their mood state as depressed, probably because of lack of any other socially approved metaphor. For a practitioner, however, it is important to make an objective assessment about the significance of this expression in terms of the range and reactivity of affect and the disproportion of depressive presentation in the context of the patient’s life situation and experiences. If depression is significant, the diagnosis of chronic fatigue syndrome becomes secondary to that of depressive disorder as fatigue may be a feature of depression. However, if chronic fatigue syndrome remains the primary diagnosis, one must remember that antidepressant drugs are neither euphoriants nor stimulants and that there is no empirical evidence for the benefit of antidepressant treatment in this syndrome, although there is a recommendation for it to be tried as an alternatp mode of treatment.

 

Source: Arya DK. Chronic fatigue syndrome. Br J Gen Pract. 1991 Nov;41(352):480. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1371803/

 

Psychiatric management of PVFS

Abstract:

Psychiatric management of PVFS (considered as a subtype of CFS) is a pragmatic approach to a disorder for which strictly biomedical treatments have so far had little to offer. Psychiatric assessment embraces a comprehensive (biopsychosocial) approach, and distinguishes factors that perpetuate the condition from those that may have precipitated it. Treatments are targeted at perpetuating factors.

Few controlled treatment trials have been reported in patients selected specifically as meeting criteria for CFS. There is evidence available, however, that suggests useful management strategies. An uncontrolled study of treatment of CFS with combined antidepressant drug and psychological treatment has produced promising results. In addition there is useful evidence arising from the study and treatment of the individual symptoms of CFS, occurring both in isolation as part of other syndromes.

The results of controlled trials of antidepressant drugs, and of psychological and rehabilitative treatment are awaited. It is already possible to offer provisional guidelines for treatment.

 

Source: Sharpe M. Psychiatric management of PVFS. Br Med Bull. 1991 Oct;47(4):989-1005. http://www.ncbi.nlm.nih.gov/pubmed/1794095

 

Antidepressant therapy in the chronic fatigue syndrome

Abstract:

The chronic fatigue syndrome is a condition receiving increasing recognition. Symptoms of depression are not infrequent and may be persistent and severe enough to warrant treatment. The controversy over the use of antidepressant therapy in this condition may present a dilemma for the general practitioner considering possible treatments. This paper draws on the literature and on the authors’ own observations of patients with the chronic fatigue syndrome to suggest guidelines for the use of antidepressant therapy.

Comment in:

Chronic fatigue syndrome. [Br J Gen Pract. 1991]

Chronic fatigue syndrome. [Br J Gen Pract. 1991]

 

Source: Lynch S, Seth R, Montgomery S. Antidepressant therapy in the chronic fatigue syndrome. Br J Gen Pract. 1991 Aug;41(349):339-42. http://www.ncbi.nlm.nih.gov/pubmed/1822108

Note: You can read the full article here: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1371759/