The Effectiveness of Citalopram for Idiopathic Chronic Fatigue
J Clin Psychiatry 2003;64:927-935
© Copyright 2014 Physicians Postgraduate Press, Inc.
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Background: Chronic fatigue greatly affects
quality of life and is a common reason for physician visits.
Patients with chronic fatigue are often treated with
Method: 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.
Conclusion: Citalopram may improve fatigue and
symptoms associated with fatigue for some patients.