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Researchers question drug for chronic fatigue syndrome

Fludrocortisone, a drug prescribed to treat low blood pressure, has little or no effect on symptoms of chronic fatigue syndrome in adults when it is used as the only form of treatment, according to a joint study by the Johns Hopkins Children's Center and the National Institute of Allergy and Infectious Diseases (NIAID). A report of the study appears in this week's Journal of the American Medical Association.

In a preliminary study published in 1995, Peter Rowe, M.D., leader of the Johns Hopkins team, reported that many patients diagnosed with chronic fatigue syndrome (CFS) developed lightheadedness, fatigue, and sometimes fainted when they stood for prolonged periods of time. When tilted head-up on a special diagnostic table, most patients developed a sudden drop in blood pressure known as neurally mediated hypotension (NMH). Some study participants reported substantial relief in their lightheadedness and CFS symptoms when treated with a combination of an increase in dietary sodium chloride (table salt), fludrocortisone, and other medications. Fludrocortisone helps to maintain a normal blood pressure by reducing the loss of sodium from the bloodstream.

The researchers conducted the current, more rigorous study to determine whether isolating one component of the treatment fludrocortisone would be equally effective in treating symptoms. Over nine weeks, 50 adults with both CFS and NMH received fludrocortisone, and 50 received a placebo. Neither group took supplemental sodium. During the study, investigators and study participants were unaware of who received the fludrocortisone or the placebo. At the end of the treatment period, 14 percent of those treated with fludrocortisone described a notable improvement in overall well-being, compared with 10 percent in the placebo group, a difference that was not deemed statistically significant by researchers.

Since this current study began in 1996, other studies have identified four drugs effective in tr
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Contact: Staci Vernick
svernick@jhmi.edu
410-223-1747
Johns Hopkins Medical Institutions
3-Jan-2001


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