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September 14, 2004
No Cure, but New Insights Gained in International Study
By Miranda Hitti
WebMD Medical News, Reviewed By Brunilda Nazario, MD
on Tuesday, September 07, 2004
Sept. 7, 2004 --The largest completed trial to date of people with chronic fatigue syndrome shows that the drug galantamine is not a potential treatment for the condition.
The study, reported in the Journal of the American Medical Association, was crystal clear: Galantamine was no better than a placebo in treating 434 people diagnosed with chronic fatigue syndrome.
The trials were conducted between 1997 and 1999 at 35 research centers in the U.K., U.S., the Netherlands, Sweden, and Belgium.
Galantamine, which is used in managing Alzheimer's disease, had shown promise in a previous chronic fatigue pilot test. But the latest trial left no doubt; it's not the hoped-for answer to chronic fatigue syndrome.
Syndrome's Symptoms
Little is known about chronic fatigue syndrome, including its cause. The condition is far more than just feeling lethargic.
The major symptom is severe fatigue lasting at least six months. Other symptoms may include headache, fever, muscle weakness, swollen glands, sore throat, and sleep problems.
Because fatigue is a symptom in many illnesses, chronic fatigue syndrome is usually diagnosed only after eliminating all other possibilities.
Chronic fatigue syndrome affects more women than men, and more adults than children.
Trial's Results
Researchers including C.V. Russell Blacker, FRCPsych, MD, of England's University of Exeter, gave some of the participants a placebo; the rest were split into groups getting different doses of galantamine.
Judging by fatigue, quality of life, sleep, and depression, the drug didn't help at any dose.
That surprised the researchers, considering the mental impairment of the participants at the start of the study.
Silver Lining
While the trial didn't yield a cure, it's still important.
For one thing, knowing what doesn't work against chronic fatigue may point researchers in a more fruitful direction.
Stephen Straus, MD, who works for the National Center for Complementary and Alternative Medicine at the National Institutes of Health, was glad to see chronic fatigue get serious scientific attention.
In an editorial in the Journal of the American Medical Association, he notes the "countless" proposals for treating chronic fatigue, including drugs, dietary interventions, and exercise strategies. Plenty of self-help books and web sites make claims, says Straus, but too few have been scientifically tested.
"The study reaffirmed the importance and feasibility of studying chronic fatigue syndrome rigorously, even if it remains a poorly understood and controversial illness," writes Straus.
SOURCES: Blacker, C. Journal of the American Medical Association, Sept. 8, 2004; vol 292: pp 1195-1204. Straus, S. Journal of the American Medical Association, Sept. 8, 2004; vol 292: pp 1234-1235. News release, Journal of the American Medical Association. WebMD Health Guide A to Z: "Chronic Fatigue Syndrome."
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