Prospective Observational Study of Treatments for Unexplained Chronic Fatigue
J Clin Psychiatry 2005;66(5):625-632
© Copyright 2015 Physicians Postgraduate Press, Inc.
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Background: Unexplained chronic fatigue is a
frequent complaint in primary care. A prospective observational
study design was used to evaluate whether certain commonly used
therapies for unexplained chronic fatigue may be effective.
Method: Subjects with unexplained chronic
fatigue of unknown etiology for at least 6 months were recruited
from the Wisconsin Chronic Fatigue Syndrome Association, primary
care clinics, and community chronic fatigue syndrome
presentations. The primary outcome measure was change in a
5-question fatigue score from 6 months to 2 years. Self-reported
interventions tested included prescribed medications,
nonprescribed supplements and herbs, lifestyle changes,
alternative therapies, and psychological support. Linear
regression analysis was used to test the association of each
therapy with the outcome measure after adjusting for
statistically significant prognostic factors.
Results: 155 subjects provided information on
fatigue and treatments at baseline and follow-up. Of these
subjects, 87% were female and 79% were middle-aged. The median
duration of fatigue was 6.7 years. The percentage of users who
found a treatment helpful was greatest for coenzyme Q10 (69% of
13 subjects), dehydroepiandrosterone (DHEA) (65% of 17 subjects),
and ginseng (56% of 18 subjects). Treatments at 6 months that
predicted subsequent fatigue improvement were vitamins (p = .08),
vigorous exercise (p = .09), and yoga (p = .002). Magnesium (p = .002)
and support groups (p = .06) were strongly associated with fatigue
worsening from 6 months to 2 years. Yoga appeared to be most
effective for subjects who did not have unclear thinking
associated with the fatigue.
Conclusion: Certain alternative therapies for
unexplained chronic fatigue, especially yoga, deserve testing in
randomized controlled trials.