Single-blind, placebo phase-in trial of two escalating doses of selegiline in the chronic fatigue syndrome.
OBJECTIVE
To perform a clinical trial of selegiline in 25 patients with chronic fatigue syndrome (CFS) where patients were told they would receive placebo or active agent at different times during the 6-week trial. We chose selegiline, a specific monoamine oxidase (MAO) B receptor inhibitor, because a prior trial of lowdose phenelzine, a nonspecific MAO inhibitor, showed a small but significant therapeutic effect.


METHODS
Questionnaires comprised of 19 tests of mood, fatigue, functional status and symptom severity were collected at the start and end of the trial as well as 2 weeks after its start. The trial was done in three 2-week blocks: in the first, 2 placebo pills were given per day; in the next, one 5-mg tablet of agent and one placebo were given per day, and in the last, a 5-mg tablet of agent was given twice a day. The plan was to compare the changes in the 19 tests during the placebo phase to those found in the active treatment phase in 19 patients completing the trial.


RESULTS
Significant improvement in 3 variables-tension/anxiety, vigor and sexual relations-was found. A significant pattern of improvement compared to worsening was found for the 19 self-report vehicles during active treatment as compared with placebo treatment. Evidence for an antidepressant effect of the drug was not found.


CONCLUSIONS
Selegiline has a small but significant therapeutic effect in CFS which appears independent of an antidepressant effect.
Natelson
B H
BH
Department of Neurosciences, University of Medicine and Dentistry of New Jersey, Newark, USA. bhn@nbunj.jvnc.net
Cheu
J
J
Hill
N
N
Bergen
M
M
Korn
L
L
Denny
T
T
Dahl
K
K
D000203:Activities of Daily Living / Q000145:classification / Q000523:psychology; D000339:Affect / Q000187:drug effects; D004334:Drug Administration Schedule; D015673:Fatigue Syndrome, Chronic / Q000175:diagnosis / Q000188:drug therapy* / Q000523:psychology; D006801:Humans; D008996:Monoamine Oxidase Inhibitors / Q000008:administration & dosage* / Q000009:adverse effects; D018696:Neuroprotective Agents / Q000008:administration & dosage* / Q000009:adverse effects; D012642:Selegiline / Q000008:administration & dosage* / Q000009:adverse effects
D008996:Monoamine Oxidase Inhibitors; D018696:Neuroprotective Agents; D012642:Selegiline