Therapy of circadian rhythm disorders in chronic fatigue syndrome: no symptomatic improvement with melatonin or phototherapy.


Journal Article

BACKGROUND:Patients with chronic fatigue syndrome (CFS) show evidence of circadian rhythm disturbances. We aimed to determine whether CFS symptoms were alleviated by melatonin and bright-light phototherapy, which have been shown to improve circadian rhythm disorders and fatigue in jet-lag and shift workers. DESIGN:Thirty patients with unexplained fatigue for > 6 months were initially assessed using placebo and then received melatonin (5 mg in the evening) and phototherapy (2500 Lux for 1 h in the morning), each for 12 weeks in random order separated by a washout period. Principal symptoms of CFS were measured by visual analogue scales, the Shortform (SF-36) Health Survey, Mental Fatigue Inventory and Hospital Anxiety and Depression Scale. We also determined the circadian rhythm of body temperature, timing of the onset of melatonin secretion, and the relationship between these. RESULTS:Neither intervention showed any significant effect on any of the principal symptoms or on general measures of physical or mental health. Compared with placebo, neither body temperature rhythm nor onset of melatonin secretion was significantly altered by either treatment, except for a slight advance of temperature phase (0.8 h; P = 0.04) with phototherapy. CONCLUSION:Melatonin and bright-light phototherapy appear ineffective in CFS. Both treatments are being prescribed for CFS sufferers by medical and alternative practitioners. Their unregulated use should be prohibited unless, or until, clear benefits are convincingly demonstrated.

Full Text

Cited Authors

  • Williams, G; Waterhouse, J; Mugarza, J; Minors, D; Hayden, K

Published Date

  • November 2002

Published In

Volume / Issue

  • 32 / 11

Start / End Page

  • 831 - 837

PubMed ID

  • 12423324

Pubmed Central ID

  • 12423324

Electronic International Standard Serial Number (EISSN)

  • 1365-2362

International Standard Serial Number (ISSN)

  • 0014-2972

Digital Object Identifier (DOI)

  • 10.1046/j.1365-2362.2002.01058.x


  • eng