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News - Citalopram shows chronic fatigue promise

Posted by jrbecker on September 19, 2003, at 15:11:43

http://www.medwire.md/News_single.aspx?newstype=3&date=20030919&story_id=19292

Citalopram shows chronic fatigue promise

J Clin Psychiatry 2003; 64: 927-935

Citalopram may offer symptomatic improvement in certain patients with idiopathic chronic fatigue, study findings show.

Chronic fatigue is a common reason for people to visit their physician and is often treated with antidepressants. In the present study, Arthur Hartz, from University of Iowa College of Medicine, USA, and team studied patients who had suffered from unexplained fatigue for at least six months. Subjects did not meet criteria for a diagnosis of chronic fatigue syndrome and their symptoms were not explained by depression, organic illness, or lifestyle behaviors.

The study comprised two arms. Thirty-one subjects were given placebo for one week and then citalopram 20-40 mg/day for two months. A separate group of 76 subjects took Siberian ginseng or placebo for two months.

Hartz et al report that in the first arm, fatigue significantly and substantially improved when subjects were switched from placebo to citalopram. This was confirmed by ratings on the Rand Vitality Index, the Global Improvement Scale, the Mood and Anxiety Symptoms Questionnaire, and self-reported somatic symptoms of headache, muscle aches, and faintness/dizziness.

The benefits associated with citalopram therapy were most pronounced in women and in individuals who had suffered fatigue for less than five years.

Women and those with less severe symptoms at baseline also showed significantly greater improvement than those taking Siberian ginseng or placebo.

Overall, citalopram was associated with no change in depression scores, although among certain subgroups - notably women - there was a significant improvement in this parameter over baseline.

"In summary, there was some evidence suggesting that citalopram benefited subsets of persons with idiopathic chronic fatigue," the authors conclude. "Further studies of how to characterize the persons benefited may improve the understanding and treatment of chronic fatigue."


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