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

AbstractBACKGROUND:
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.
AuthorsA J Wearden, R K Morriss, R Mullis, P L Strickland, D J Pearson, L Appleby, I T Campbell, J A Morris
JournalThe British journal of psychiatry : the journal of mental science (Br J Psychiatry) Vol. 172 Pg. 485-90 (Jun 1998) ISSN: 0007-1250 [Print] ENGLAND
PMID9828987 (Publication Type: Clinical Trial, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
Chemical References
  • Antidepressive Agents, Second-Generation
  • Fluoxetine
Topics
  • Adult
  • Antidepressive Agents, Second-Generation (therapeutic use)
  • Combined Modality Therapy
  • Double-Blind Method
  • Exercise Therapy (methods)
  • Fatigue Syndrome, Chronic (drug therapy, rehabilitation)
  • Female
  • Fluoxetine (therapeutic use)
  • Humans
  • Male
  • Prospective Studies
  • Treatment Outcome
  • Treatment Refusal

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