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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
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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 

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Footnotes

†.

See commentary pp. 491–492, this issue.

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