Cognitive-behavioural therapy <i>v</i>. mirtazapine for chronic fatigue and neurasthenia: randomised placebo-controlled trial

Stubhaug, Bjarte; Lie, Stein Atle; Ursin, Holger; Eriksen, Hege R.

doi:10.1192/bjp.bp.106.031815

Cited by 26 publications

(22 citation statements)

References 24 publications

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“…The study included a mixed crossover-combination design, and at 24 weeks the treatment group initially receiving CCBT for 12 weeks followed by mirtazapine for 12 weeks showed significant improvement compared with the other treatment groups (including the group receiving mirtazapine followed by CCBT) on the Fatigue Scale and the Clinical Global Impression Scale. This study supports the notion that CFS treatment should include combination of behavioral and pharmacological therapies, with particular importance on the proper timing and sequence of therapeutic interventions [60].…”

Section: Noradrenergic and Specific Serotonin Antagonistsupporting

confidence: 67%

“…A recent RCT [60] in CFS patients (n = 72) comparing comprehensive cognitive behavioral therapy (CCBT) to mirtazapine and placebo over 12 weeks demonstrates superiority of CCBT to the other treatments and indicates that mirtazapine is not superior to placebo on the Fatigue Scale. The study included a mixed crossover-combination design, and at 24 weeks the treatment group initially receiving CCBT for 12 weeks followed by mirtazapine for 12 weeks showed significant improvement compared with the other treatment groups (including the group receiving mirtazapine followed by CCBT) on the Fatigue Scale and the Clinical Global Impression Scale.…”

Section: Noradrenergic and Specific Serotonin Antagonistmentioning

confidence: 97%

“…The order of interventions may be important, and in particular, a robust response has been demonstrated with behavioral intervention followed by pharmacological treatment [60]. Hence, multimodal approach for individual patient with CFS would be proper to optimize and maximize the treatment effects.…”

Section: Expert Opinionmentioning

confidence: 98%

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Pharmacological treatment of chronic fatigue syndrome: focusing on the role of antidepressants

Pae

Marks

Patkar

et al. 2009

Expert Opinion on Pharmacotherapy

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Chronic fatigue syndrome (CFS) is characterized by chronic, medically unexplained fatigue associated with effort- and stress-intolerance, widespread pain, and impairment in sleep and concentration. Although this constellation of symptoms is highly prevalent in clinical practice, the pathophysiological mechanisms underlying CFS are poorly understood. Current evidence indicates similarities in symptomatology, and possibly etiology and pathogenesis, between CFS and depression. Additionally, there is significant overlap between CFS and the syndrome of fibromyalgia for which antidepressants have shown consistent efficacy. Data regarding antidepressant treatment of CFS is less copious and less uniformly positive, such that antidepressant use in CFS remains controversial. The current review aims to summarize available data related to antidepressants and other psychotropic agents in CFS to provide a platform for clinicians to make decisions in their treatment of this challenging syndrome. We identified relevant studies through a PubMed literature search with a combination of the following search terms: 'fatigue,' 'depression,' 'antidepressant,' 'etiology' (e.g., 'neurobiology,' 'neurotransmitter,' 'genetic'), 'diagnosis,' and 'treatment' (e.g., 'antidepressant' plus the specific name). In addition, studies were also identified via the reference sections of retrieved articles. The authors thoroughly reviewed major findings from the scanned literatures and eventually synthesized them, providing summary, interpretation, and future directions.

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Section: Noradrenergic and Specific Serotonin Antagonistsupporting

confidence: 67%

Section: Noradrenergic and Specific Serotonin Antagonistmentioning

confidence: 97%

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Pharmacological treatment of chronic fatigue syndrome: focusing on the role of antidepressants

Pae

Marks

Patkar

et al. 2009

Expert Opinion on Pharmacotherapy

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“…10 Mirtazapine, an antidepressant that enhances central noradrenergic and serotonergic activity, was evaluated in a 24-week mixed cross-over combination design. 11 Patients initially undergoing cognitive-behavioral treatment for 12 weeks followed by mirtazapine for 12 weeks reported significant improvement in fatigue compared with other treatment groups. These results suggest that CFS may respond to a combination of pharmacologic and nonpharmacologic therapies, with the sequence and timing of the interventions having potential importance for their effectiveness.…”

Section: Introductionmentioning

confidence: 97%

A Randomized, Placebo-Controlled, Double-Blinded Trial of Duloxetine in the Treatment of General Fatigue in Patients With Chronic Fatigue Syndrome

et al. 2015

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“…However, a more recent review has suggested that CBT shows clinical improvements in 40% of people versus a 26% improvement in usual care (15). Group-based CBT combined with body awareness and exercise training has also been shown to be effective for CFS in recent work (39). In line with our stress model of CFS symptom exacerbation, the present study focused on testing the effects of group-based CBSM intervention in individuals diagnosed with CFSand our findings suggest that CBSM may reduce CFS symptoms in parallel with improvements in perceived stress, negative mood, and quality of life.…”

Section: Discussionmentioning

confidence: 99%

A pilot study of cognitive behavioral stress management effects on stress, quality of life, and symptoms in persons with chronic fatigue syndrome

Lopez

Antoni

Penedo

et al. 2011

Journal of Psychosomatic Research

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OBJECTIVE The present pilot study was designed to test the effects of a 12 week group-based Cognitive Behavioral Stress Management (CBSM) intervention on stress, quality of life, and symptoms in chronic fatigue syndrome (CFS). We hypothesized that participants randomized to CBSM would report improvements in perceived stress, mood, quality of life, and CFS symptomatology from pre-to-post intervention compared to those receiving a psychoeducational (PE) seminar control. METHOD We recruited 69 persons with a bonafide diagnosis of CFS and randomized 44 to CBSM and 25 to PE. Participants completed the Perceived Stress Scale (PSS),Profile of Mood States (POMS), Quality of Life Inventory (QOLI), and a CDC-based CFS symptom checklist pre- and post-intervention. RESULTS Repeated Measures ANOVA revealed a significant group × time interaction for PSS, POMS-total mood disturbance, and QOLIscores, such that participants in CBSM evidenced greater improvements than those in PE. Participants in CBSM also reported decreases in severity of CFS symptoms vs. those in PE. CONCLUSIONS Results suggest that CBSM is beneficial for managing distress, improving quality of life, and alleviating CFS symptom severity.

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Cognitive-behavioural therapy v. mirtazapine for chronic fatigue and neurasthenia: randomised placebo-controlled trial

Abstract: Multimodal interventions may have positive treatment effects in chronic fatigue syndrome. Sequence of interventions seem to be of importance.

Cited by 26 publications

References 24 publications

Pharmacological treatment of chronic fatigue syndrome: focusing on the role of antidepressants

Pharmacological treatment of chronic fatigue syndrome: focusing on the role of antidepressants

A Randomized, Placebo-Controlled, Double-Blinded Trial of Duloxetine in the Treatment of General Fatigue in Patients With Chronic Fatigue Syndrome

A pilot study of cognitive behavioral stress management effects on stress, quality of life, and symptoms in persons with chronic fatigue syndrome

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