A Randomized, Double-Blind, Placebo-Controlled Trial of Moclobemide in Patients With Chronic Fatigue Syndrome
J Clin Psychiatry 2000;61(9):643-648
© Copyright 2015 Physicians Postgraduate Press, Inc.
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Background: Chronic fatigue syndrome is
characterized by prolonged and disabling fatigue and a range of
neuropsychiatric symptoms including depressed and/or irritable
mood. To date, no medical or psychotropic therapies have provided
clear symptomatic benefit.
Method: Ninety patients with chronic fatigue
syndrome, diagnosed with our system that approximates CDC
criteria, participated in a randomized, placebo-controlled,
double-blind trial of 450 to 600 mg/day of moclobemide, a novel
reversible inhibitor of monoamine oxidase-A.
Results: Fifty-one percent (24/47) of patients
receiving moclobemide improved compared with 33% (14/43) of
patients receiving placebo (odds ratio = 2.16, 95% confidence
interval [CI] = 0.9 to 5.1). Drug response was best characterized
symptomatically by an increase in the subjective sense of vigor
and energy rather than a reduction in depressed mood. The effect
of moclobemide on subjective energy was detectable within the
first 2 weeks of treatment and increased across the course of the
study. The greatest reduction in clinician-rated disability was
in patients with concurrent immunologic dysfunction (mean
difference in standardized units of improvement = 0.8, 95% CI =
0.03 to 1.6).
Conclusion: Moclobemide produces some
improvement in key symptoms experienced by patients with chronic
fatigue syndrome. This effect is not dependent on the presence of
concurrent psychological distress and is likely to be shared with
other monoamine oxidase inhibitors.