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Monday, November 23, 2009

Tired all the time?

Looking for a way to help people with chronic fatigue syndrome

By Helen Fields

12/2/04

Chronic fatigue syndrome is a long-term, depressing set of symptoms. Mostly it involves being profoundly fatigued, so bad that it's impossible to get out of bed, but it may also include fever, headache, and muscle weakness. No one knows what causes it, and people with the syndrome can suffer for years.

What the researchers wanted to know: Does the Alzheimer's drug galantamine hydrobromide help patients with chronic fatigue syndrome?

What they did: Four hundred thirty-four patients with chronic fatigue syndrome in five countries were randomly assigned to take galantamine or a placebo for 16 weeks. They were actually divided into five groups; one group received the placebo, and the other four got different amounts of the drug—2.5 milligrams to 10 milligrams, three times a day. Neither the patients nor the doctors knew who was getting which treatment.

What they found: There was very little difference between galantamine and a placebo. On the upside, the drug seemed safe; but that's not much comfort when it doesn't relieve the symptoms.

What the study means to you: Well, don't start taking galantamine for chronic fatigue syndrome. In an editorial that accompanies the article on this study, Stephen Straus, director of the National Institutes of Health's National Center for Complementary and Alternative Medicine, writes that this study is actually quite useful, since it suggests that chronic fatigue syndrome is not caused by problems with the cholinergic pathways, the aspect of the nervous system targeted by galantamine. Because the origins of the syndrome are so mysterious, any hint helps. He writes that the only treatments shown to help many patients are cognitive-behavioral therapy and exercise.

Find out more: Chronic fatigue syndrome: an explanation by the Centers for Disease Control and Prevention, which came up with the standard diagnosis for CFS used in this study. It also debunks some rumors on that site: In case you were wondering, the CDC says there is no evidence that people with chronic fatigue syndrome lose their fingerprints.

Read the article: Blacker, C.V.R., et al. "Effect of Galantamine Hydrobromide in Chronic Fatigue Syndrome." Journal of the American Medical Association. Sept. 8, 2004, Vol. 292, No. 10, pp. 1195-1204.

Abstract online: http://jama.ama-assn.org

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