Duloxetine (Cymbalta) May Help Some Symptoms in ME/CFS but not Fatigue

Cort

Founder of Health Rising and Phoenix Rising
Staff member
Duloxetine or Cymbalta is FDA approved for Fibromyalgia. In this relatively small trial in ME/CFS it was found to help with mental fatigue, pain, and a global measure of severity but not with fatigue. That may not be surprising given that Cymbalta's been shown to be helpful with depression, anxiety and pain but apparently not with fatigue.

From WebMD

"Cymbalta belongs to a class of medications called serotonin and norepinephrine reuptake inhibitors (SNRIs). The FDA previously approved Cymbalta for the treatment of depression, generalized anxiety disorder, and diabetic peripheral neuropathic pain. The agency approved Cymbalta for the management of fibromyalgia in adults in June 2008."

"Researchers think that Cymbalta helps calm down these pain signals by increasing the level of two naturally occurring substances called serotonin and norepinephrine. These substances, which are found in the brain and other parts of the nervous system, can affect mood and are believed to help control and suppress feelings of pain"

Psychosomatics. 2014 Dec 16. pii: S0033-3182(14)00193-5. doi: 10.1016/j.psym.2014.12.003. [Epub ahead of print]
A Randomized, Placebo-Controlled, Double-Blinded Trial of Duloxetine in the Treatment of General Fatigue in Patients With Chronic Fatigue Syndrome.

Arnold LM1, Blom TJ2, Welge JA2, Mariutto E3, Heller A3.
Author information

  • 1Women's Health Research Program, Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, OH (LMA, EM, AH). Electronic address: Lesley.Arnold@uc.edu.
  • 2Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, OH (TJB, JAW).
  • 3Women's Health Research Program, Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, OH (LMA, EM, AH).
Abstract

OBJECTIVE:

To assess the efficacy and safety of duloxetine in patients with chronic fatigue syndrome.
METHODS:

A 12-week, randomized, double-blind study was designed to compare duloxetine 60-120mg/d (n = 30) with placebo (n = 30) for efficacy and safety in the treatment of patients with chronic fatigue syndrome. The primary outcome measure was the Multidimensional Fatigue Inventory general fatigue subscale (range: 4-20, with higher scores indicating greater fatigue). Secondary measures were the remaining Multidimensional Fatigue Inventory subscales, Brief Pain Inventory, Medical Outcomes Study Short Form-36, Hospital Anxiety and Depression Scale, Centers for Disease Control and Prevention Symptom Inventory, Patient Global Impression of Improvement, and Clinical Global Impression of Severity. The primary analysis of efficacy for continuous variables was a longitudinal analysis of the intent-to-treat sample, with treatment-by-time interaction as the measure of effect.
RESULTS:

The improvement in the Multidimensional Fatigue Inventory general fatigue scores for the duloxetine group was not significantly greater than for the placebo group (P = 0.23; estimated difference between groups at week 12 = -1.0 [95% CI: -2.8, 0.7]). The duloxetine group was significantly superior to the placebo group on the Multidimensional Fatigue Inventory mental fatigue score, Brief Pain Inventory average pain severity and interference scores, Short Form-36 bodily pain domain, and Clinical Global Impression of Severity score. Duloxetine was generally well tolerated.
CONCLUSION:

The primary efficacy measure of general fatigue did not significantly improve with duloxetine when compared with placebo. Significant improvement in secondary measures of mental fatigue, pain, and global measure of severity suggests that duloxetine may be efficacious for some chronic fatigue syndrome symptom domains, but larger controlled trials are needed to confirm these results.
 

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