YOU ARE NOW CONNECTED TO THE TOXLINE (1981 FORWARD, NON-ROYALTY) FILE. ==FATIGUE SYNDROME, CHRONIC== 3 AUTHOR White PD AUTHOR Cleary KJ TITLE An open study of the efficacy and adverse effects of moclobemide in patients with the chronic fatigue syndrome. SOURCE Int Clin Psychopharmacol; VOL 12, ISS 1, 1997, P47-52 ABSTRACT There is a strong association between the chronic fatigue syndrome and both depressive illness and sleep disturbance, but the efficacy of antidepressants is uncertain. We studied the efficacy and adverse effects of moclobemide in patients with chronic fatigue syndrome, stratifying the sample both by co-morbid major depressive illness and by sleep disturbance. Forty-nine patients with chronic fatigue syndrome were recruited. Patients were given moclobemide up to 600 mg a day for 6 weeks. Four (8%) patients dropped out, three because of adverse effects. Adverse effects wee otherwise mild and transient. On analysing the whole sample, there were significant but small reductions in fatigue, depression, anxiety and somatic amplification, as well as a modest overall improvement. The greatest improvement occurred in those individuals who had a co-morbid major depressive illness, with seven out of 14 (50%) of such individuals rating themselves as "much better" by 6 weeks, compared to six out of 31 (19%) of those who were not depressed (31% difference, 95% CI 1-60%, P = 0.04). Sleep disturbance had no effect on outcome. Moclobemide may be indicated in patients with chronic fatigue syndrome and a co-morbid major depressive disorder. A randomized, placebo-controlled trial is needed to confirm this. These results do not support moclobemide as an effective treatment of chronic fatigue syndrome in the absence of a major depressive disorder. 4 AUTHOR Plioplys AV AUTHOR Plioplys S TITLE Amantadine and L-carnitine treatment of Chronic Fatigue Syndrome. SOURCE Neuropsychobiology; VOL 35, ISS 1, 1997, P16-23 ABSTRACT Carnitine is essential for mitochondrial energy production. Disturbance in mitochondrial function may contribute to or cause the fatigue seen in Chronic Fatigue Syndrome (CFS) patients. Previous investigations have reported decreased carnitine levels in CFS. Orally administered L-carnitine is an effective medicine in treating the fatigue seen in a number of chronic neurologic diseases. Amantadine is one of the most effective medicines for treating the fatigue seen in multiple sclerosis patients. Isolated reports suggest that it may also be effective in treating CFS patients. Formal investigations of the use of L-carnitine and amantadine for treating CFS have not been previously reported. We treated 30 CFS patients in a crossover design comparing L-carnitine and amantadine. Each medicine was given for 2 months, with a 2-week washout period between medicines. L-Carnitine or amantadine was alternately assigned as fist medicine. Amantadine was poorly tolerated by the CFS patients. Only 15 were able to complete 8 weeks of treatment, the others had to stop taking the medicine due to side effects. In those individuals who completed 8 weeks of treatment, there was no statistically significant difference in any of the clinical parameters that were followed. However, with L-carnitine we found statistically significant clinical improvement in 12 of the 18 studied parameters after 8 weeks of treatment. None of the clinical parameters showed any deterioration. The greatest improvement took place between 4 and 8 weeks of L-carnitine treatment. Only 1 patient was unable to complete 8 weeks of treatment due to diarrhea. L-Carnitine is a safe and very well tolerated medicine which improves the clinical status of CFS patients. In this study we also analyzed clinical and laboratory correlates of CFS symptomatology and improvement parameters. 2 AUTHOR Magnusson AE AUTHOR Nias DK AUTHOR White PD TITLE Is perfectionism associated with fatigue? SOURCE J Psychosom Res; VOL 41, ISS 4, 1996, P377-83 ABSTRACT Perfectionism has been implicated as a vulnerability factor in the development of chronic unexplained fatigue. In the present study, different components of fatigue and perfectionism were studied in 121 female nurses. They completed a postal questionnaire assessing current (state) and usual (trait) fatigue, and dimensions of personality including six components of perfectionism. Night-shift work was associated with state, but not trait, fatigue. Negative, but not positive, components of perfectionism were associated with mental trait fatigue in particular, but also with physical trait fatigue. In contrast, the associations with positive perfectionism tended to be inverse. Multiple regression modeling indicated that neuroticism as well as negative perfectionism were separately associated with trait fatigue. We suggest that negative aspects of perfectionism may cause maladaptive coping strategies which predispose individuals to fatigue. 4 AUTHOR Marshall PS AUTHOR Watson D AUTHOR Steinberg P AUTHOR Cornblatt B AUTHOR Peterson PK AUTHOR Callies A AUTHOR Schenck CH TITLE An assessment of cognitive function and mood in chronic fatigue syndrome. SOURCE Biol Psychiatry; VOL 39, ISS 3, 1996, P199-206 ABSTRACT Data were gathered regarding the associates of chronic fatigue syndrome (CFS) with: (1) speed of cognitive processing, (2) motor speed, (3) ability to sustain attention, and (4) mood. Patients were given a brief neuropsychological test battery before and after double-blind treatment with terfenadine or placebo and completed a daily mood rating scale (Positive and Negative Affect Schedule) during the study. CFS patients exhibited slower cognitive processing and motor speed and lower positive affect, as compared to data reported from previous studies of healthy subjects and other patient groups; however, CFS patients did not exhibit deficits in sustained attention in comparison to other groups. The CFS patients' ability to attend to verbal versus figural stimuli and mood ratings were different from those reported in studies of patients with depression. Because of methodological limitations, these findings are preliminary, but they encourage further assessment of cognitive dysfunction and mood in CFS.