Low-dose Hydrocortisone in Chronic Fatigue Syndrome: A Randomised Crossover

BACKGROUND: Reports of mild hypocortisolism in chronic fatigue syndrome led us to postulate that low-dose hydrocortisone therapy may be an effective treatment.

METHODS: In a randomised crossover trial, we screened 218 patients with chronic fatigue. 32 patients met our strict criteria for chronic fatigue syndrome without co-morbid psychiatric disorder. The eligible patients received consecutive treatment with low-dose hydrocortisone (5 mg or 10 mg daily) for 1 month and placebo for 1 month; the order of treatment was randomly assigned. Analysis was by intention to treat.

INTERPRETATION: In some patients with chronic fatigue syndrome, low-dose hydrocortisone reduces fatigue levels in the short term. Treatment for a longer time and follow-up studies are needed to find out whether this effect could be clinically useful.

Source: Department of Psychological Medicine, Guy's King's and St Thomas' School of Medicine and the Institute of Psychiatry, London, UK. a.cleare@iop.bpmf.ac.uk. Lancet, 353(9151):455-8 1999 Feb 6.

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