The effectiveness of citalopram for idiopathic chronic fatigue.
BACKGROUND
Chronic fatigue greatly affects quality of life and is a common reason for physician visits. Patients with chronic fatigue are often treated with antidepressants.


METHODS
Prior to enrollment, all subjects had substantial fatigue for 6 months or more that was not explained by depression, organic illness, or lifestyle behaviors. Patients already taking an antidepressant were excluded from the study. Two designs were used. (1) Thirty-one subjects were given placebo for 1 week and then citalopram, 20 to 40 mg/day, for 2 months. Statistical testing evaluated whether fatigue (measured with the Rand Vitality Index) was reduced after citalopram was started. (2) Fatigue changes for subjects taking citalopram were compared with fatigue changes after 1 month and 2 months for 76 similar subjects taking an ineffective treatment.


RESULTS
In design 1, fatigue for subjects taking citalopram was significantly and substantially reduced when subjects were switched from placebo to citalopram, p <.05. Benefits at 2 months were greatest for subjects who had fatigue less than 5 years, p <.01, and women, p <.01. In design 2, fatigue scores for subjects taking citalopram were not significantly better than the comparison group for all subjects but were significantly better at 2 months for subjects with less severe fatigue at baseline, p =.005, and for women, p =.08. Depression scores were not significantly better for citalopram subjects overall (p >.10) but were for certain subgroups. For all subjects, citalopram was associated with greater decrease in headaches and muscle aches at 1 month, p <.01.


CONCLUSIONS
Citalopram may improve fatigue and symptoms associated with fatigue for some patients.
Hartz
Arthur J
AJ
Department of Family Medicine, University of Iowa College of Medicine, Iowa City 52242-1097, USA. arthur-hartz@uiowa.edu
Bentler
Suzanne E
SE
Brake
Kathleen A
KA
Kelly
Michael W
MW
D000328:Adult; D000368:Aged; D002908:Chronic Disease; D015283:Citalopram / Q000627:therapeutic use*; D004334:Drug Administration Schedule; D005221:Fatigue / Q000175:diagnosis / Q000188:drug therapy* / Q000523:psychology; D015673:Fatigue Syndrome, Chronic / Q000175:diagnosis / Q000188:drug therapy / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D010919:Placebos; D011569:Psychiatric Status Rating Scales; D012107:Research Design; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use*; D012720:Severity of Illness Index; D016896:Treatment Outcome
D015283:Citalopram; D010919:Placebos; D017367:Selective Serotonin Reuptake Inhibitors