Hostname: page-component-78c5997874-ndw9j Total loading time: 0 Render date: 2024-11-17T19:11:52.579Z Has data issue: false hasContentIssue false
  • English
  • Français

Randomised, double-blind, placebo-controlled treatment trial of fluoxetine and graded exercise for chronic fatigue syndrome†

Published online by Cambridge University Press:  03 January 2018

Alison J. Wearden ,
Richard K. Morriss ,
Ricky Mullis ,
P. L. Strickland ,
David J. Pearson ,
Louis Appleby ,
Iain T. Campbell  and
Julie A. Morris
Alison J. Wearden
Affiliation:
University of Manchester, Department of Psychiatry, Withington Hospital, Manchester
Richard K. Morriss*
Affiliation:
University of Manchester Department of Community Psychiatry and Guild NHS Trust, Royal Preston Hospital
Ricky Mullis
Affiliation:
University of Manchester Department of Medicine, Withington Hospital, Manchester
David J. Pearson
Affiliation:
University of Manchester Department of Medicine, Withington Hospital, Manchester
Louis Appleby
Affiliation:
University of Manchester, Department of Psychiatry, Withington Hospital, Manchester
Iain T. Campbell
Affiliation:
University of Manchester, Department of Anaesthesia, Withington Hospital, Manchester
Julie A. Morris
Affiliation:
University of Manchester, Department of Medical Statistics, Withington Hospital, Manchester
*
Dr Richard Morriss, Guild NHS Trust, Royal Preston Hospital, Sharoe Green Lane, Preston PR2 9HT. Fax: 01772 710772
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

The Joint Working Group of the Royal Colleges of Physicians, Psychiatrists and General Practitioners (1996) recommended graded exercise and antidepressants for patients with chronic fatigue syndrome. We assessed efficacy and acceptability of these treatments.

Method

Six-month prospective randomised placebo and therapist contact time controlled trial with allocation to one of four treatment cells: exercise and 20 mg fluoxetine, exercise and placebo drug, appointments only and 20 mg fluoxetine, appointments and placebo drug. Drug treatment was double blind and patients were blind to assignment to exercise or appointments.

Results

Ninety-six (71%) of 136 patients completed the trial. Patients were more likely to drop out of exercise than non-exercise treatment (P=0.05). In an intention to treat analysis, exercise resulted in fewer patients with case level fatigue than appointments only at 26 weeks (12 (18%) v. 4 (6%) respectively P=0.025) and improvement in functional work capacity at 12(P=0.005) and 26 weeks (P=0.03). Fluoxetine had a significant effect on depression at week 12 only (P=0.04). Exercise significantly improved health perception (P=0.012) and fatigue (P=0.028) at 28 weeks.

Conclusions

Graded exercise produced improvements in functional work capacity and fatigue, while fluoxetine improved depression only.

Type
Papers
Information
The British Journal of Psychiatry , Volume 172 , Issue 6 , June 1998 , pp. 485 - 490
Copyright
Copyright © 1998 The Royal College of Psychiatrists 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

†.

See commentary pp. 491–492, this issue.

References

Allied Dunbar (1992) National Fitness Survey. London: Sports Council and Health Education Authority.Google Scholar
American College of Sports Medicine (1995) Guidelines for Exercise Testing and Prescription (5th edn). Baltimore, MD: Williams and Wilkins.Google Scholar
American Psychiatric Association (1987) Diagnostic and Statistical Manual of Mental Disorders (3rd edn, revised) (DSM–III–R). Washington, DC: APA.Google Scholar
Behan, P. O. Haniffah, B. A. G. Doogan, D. P. et al (1994) A pilot study of sertraline for the treatment of chronic fatigue syndrome. Clinical Infectious Disease, 18 (suppl.), S111.Google Scholar
Borg, G. (1982) Psychophysical basis of perceived exertion. Medical Science in Sports and Exercise, 14, 377–381.CrossRefGoogle Scholar
Butler, S. Chalder, T. Ron, M. et al (1991) Cognitive behaviour therapy in chronic fatigue syndrome. Journal of Neurology, Neurosurgery and Psychiatry, 54, 153–158.Google Scholar
Chalder, T. Berelowitz, G. Pawtikowska, T. et al (1993) Development of a fatigue scale. Journal of Psychosomatic Research, 37, 147–153.Google Scholar
Deale, A. Chalder, T. Marks, I. et al (1997) Cognitive behaviour therapy for chronic fatigue syndrome: a randomised controlled trial. American Journal of Psychiatry, 154, 408–414.Google Scholar
Fulcher, K. Y. & White, P. D. (1997) Randomised controlled trial of graded exercise in patients with the chronic fatigue syndrome. British Medical Journal, 314, 1647–1657.Google Scholar
Joint Working Group of the Royal Colleges of Physicians, Psychiatrists and General Practitioners (1996) Chronic Fatigue Syndrome. Council Report CR54. London: Royal College of Physicians.Google Scholar
Lewis, G. Pelosi, A. J. Araya, R. et al (1992) Measuring psychiatric disorder in the community: a standardised assessment for use by lay interviewers. Psychological Medicine, 22, 465–486.Google Scholar
McArdle, W. D. Katch, F. I. & Katch, V. L. (1994) Essentials of Exercise Physiology. Philadelphia: Lea and Febiger.Google Scholar
Morriss, R. K. Sharpe, M. Sharpley, A. L. et al (1993) Abnormalities of sleep in patients with chronic fatigue syndrome. British Medical Journal, 306, 1161–1164.CrossRefGoogle ScholarPubMed
Sharpe, M. C. Arc hard, L. C. Banatvala, J. E., et al (1991) A report – chronic fatigue syndrome: guidelines for research. Journal of the Royal Society of Medicine, 384, 118–121.CrossRefGoogle Scholar
Sharpe, M. C. Hawton, K. Seagrott, V. et al (1992) Follow up of patients presenting with fatigue to an infectious diseases clinic. British Medical Journal, 305, 309–315.CrossRefGoogle Scholar
Sharpe, M. C. Hawton, K. Simkin, S. et al (1996) Cognitive behaviour therapy for chronic fatigue syndrome: a randomised controlled trial. British Medical Journal, 312, 22–26.CrossRefGoogle Scholar
Stewart, A. L. Hays, R. D. & Ware, J. E. (1988) The Medical Outcomes Survey Short-Form General Health Survey: Reliability and validity in a patient population. Medical Care, 26, 724–734.CrossRefGoogle Scholar
Vercoulen, J. H. Swanink, C. M. Zitman, F. G. et al (1996) Randomised double-blind, placebo-controlled study of fluoxetine in chronic fatigue syndrome. Lancet, 347, 858–861.Google Scholar
White, P. D. & Cleary, K. J. (1997) An open study of the efficacy and adverse effects of moclobemide in patients with the chronic fatigue syndrome. International Clinical Psychopharmacology, 12, 47–52.CrossRefGoogle ScholarPubMed
Zigmond, A. S. & Snaith, R. P. (1983) The Hospital Anxiety and Depression Scale (HAD). Acta Psychiatrica Scandinavica, 67, 361–370.CrossRefGoogle Scholar
Submit a response

eLetters

No eLetters have been published for this article.