Valacyclovir treatment of chronic fatigue in adolescents.

[PDXhausted]

This popped up on pubmed this morning. Not sure what to make of the language, but the result was interesting.

http://www.ncbi.nlm.nih.gov/pubmed/24445302

Adv Mind Body Med. 2014 Winter;28(1):4-14.
Valacyclovir treatment of chronic fatigue in adolescents.
Henderson TA.
Abstract
Chronic fatigue syndrome (CFS) presents with fatigue, low motivation, diminished mood, and reduced activity, all symptoms having extensive diagnostic overlaps with depression. Studies have linked chronic viral infections with CFS, and antiviral therapy has effectively treated CFS in adult patients. In a retrospective case series, 15 adolescents and preteens referred to the author for treatment-resistant depression or mood disorder were evaluated and found to have met the Fukuda diagnostic criteria for CFS. While a subset (4/15) had been diagnosed in the past with CFS, the majority had a current diagnosis of depression or a mood disorder. The Diagnostic and Statistical Manual-IV Text Revision (DSM-IV TR) criteria for depression were not met in all patients, although 3 cases of mood disorder not otherwise specified (MD-NOS) and 1 case of Tourette syndrome (TS) plus MD-NOS were diagnosed. Baseline scores on the Children's Depression Inventory (CDI) were below the cutoff for depression in all but 1 patient. Baseline self-assessment scales for CFS or fatiguewere obtained and sleep was evaluated with sleep logs. All patients were treated subsequently with valacyclovir, with 93% having a positive response. At the end of treatment, scores on fatigue self-assessment scales improved significantly (P < .001). Vigor subscale scores also improved significantly (P < .001). Some patients experienced complete resolution of symptoms. Although not every patient was tested, available laboratory testing revealed increased counts of natural killer (NK) cells and decreased human herpesvirus 6 (HHV-6) antibody titers in all patients who responded to valacyclovir. This article discusses the significance of infectious agents in the pathogenesis of psychiatric symptoms. The study's data support an intriguing hypothesis that a portion of treatment-resistant depression in fact may be undiagnosed CFS or otherchronic viral infection.

 

[heapsreal]

I guess its saying that cases of depression etc could be viral infections. Maybe those presentingwith depression at the docs sshould be tested for those and given avs instead of thrown prozac??

Early days I guess but this would reduce the amount of people needing to see psychobabblers. They wouldn't be happy with this as they wouldn't want someone else to cure their patients.

 

[anciendaze]

Please note that they are talking about increased counts of NK cells, while the general consensus about ME/CFS is that NK cells are reduced in number or less active. I'm guessing they are treating adolescent fatigue/depression earlier than is possible with a typical CFS diagnosis. This would say the disease initially presents with increased viral titers and NK activity, which then changes as immune dysfunction sets in. I'm really curious about whether HHV6/7 can pull the same trick as EBV is now reported to do, depleting cells and crippling response.

Don't assume all psychiatrists are psychobabblers. These appear to be acting like there was a good reason for their medical degrees. In my opinion, many psychiatrists would be happy to stop seeing the same depressed and depressing patients over and over.

 

[wdb]

It's a great result; I want to believe. Looking the methods though by which it was reached doesn't leave me with much confidence

 

[NK17]

I was recently exchanging thoughts and ideas with a dear friend whose son is severely autistic and he mentioned a case of complete remission from autism after prolonged treatment with Valtrex in one of his acquaintance's kid.

Food for thoughts …

The main problem is finding doctors/pediatricians knowledgeable or at least open to a trial of antivirals when there are "neuro-psychiatric" and cognitive symptoms and high IgG to some of these nasty neurotropic herpes viruses.

 

[anciendaze]

I was recently exchanging thoughts and ideas with a dear friend whose son is severely autistic and he mentioned a case of complete remission from autism after prolonged treatment with Valtrex in one of his acquaintance's kid...

Here's a link to a paper on such a case. If you search for such cases, use the generic name, valacyclovir, instead of Valtrex.