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Nefazodone for patients with Chronic Fatigue Syndrome (CFS)

  [ 82 votes ]   [ Discuss This Article ] • April 10, 1999

OBJECTIVE: Patients with chronic fatigue syndrome (CFS)
present with a variety of musculoskeletal, neurocognitive,
sleep disturbance and mood symptoms. An open evaluation of the
clinical utility of the novel antidepressant compound,
nefazodone, was completed.

METHOD: Ten patients with CFS
presenting for assessment by a specialist psychiatrist were
treated with nefazodone. Patients treated within this
specialist service are also advised to engage in appropriate
behavioural and sleep-wake cycle strategies to improve their
level of functioning.

RESULTS: Of the 10 patients, eight (80%)
reported at least some improvement in the key symptom of
fatigue, with four (40%) reporting moderate or marked symptom
relief. Additionally, sleep disturbance and mood were both
moderately or markedly improved in seven (70%) and eight (80%)
of the patients, respectively. Five of the patients (50%)
achieved at least a moderate improvement in overall functional
outcome and were able to return to work or their previous
level of role function. The mean dose of nefazodone was 370
mg/day (range = 200-800 mg), with a strong preference for
nocturnal dosing. Seven of the patients had previously failed
to respond to moclobemide, while seven had previously failed
to respond to conventional antidepressant therapy.

Nefazodone appears to be worthy of further systematic
investigation in patients with CFS. Given its effects on
sleep, mood and anxiety symptoms, it may have particular
advantages in patients with this disorder.

Hickie I

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