Psychiatry Advisor's Top Ten Articles of 2015

Never Give Up

Collecting improvements, until there's a cure.
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Psychiatry Advisor sent me an mail with the above title. Number three is "The Role of Antiviral Therapy in Chronic Fatigue Treatment".

The article is written by Theodore Henderson, MD, PhD, who brought us "Valacyclovir Treatment of Chronic Fatigue in Adolescents", http://www.ncbi.nlm.nih.gov/pubmed/24445302 in 2014.

He invokes the IOM report, says it aligns with his clinical experience with both adolescents and adults, and favorably compares antiviral therapy outcomes to CBT and GET while slamming the PACE trial methodology.

Number three!
 

TiredSam

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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.
I don't have low motivation. Anyone got low motivation?

Of course these two articles are very much to be welcomed. I just can't help being highly motivated to see our illness described accurately.
 

Effi

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I don't have low motivation. Anyone got low motivation?

Of course these two articles are very much to be welcomed. I just can't help being highly motivated to see our illness described accurately.
I know what you mean! Lately what's been bugging me a lot is the word 'fatigue'. What is fatigue? Is that even a symptom worth mentioning? It's vague as can be.

I definitely don't have low motivation or diminished mood either. But apart from that I'm glad to see this article in a top 3. That is progress.
 

alex3619

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He invokes the IOM report, says it aligns with his clinical experience with both adolescents and adults, and favorably compares antiviral therapy outcomes to CBT and GET while slamming the PACE trial methodology.
If you properly apply EBM methodology, which is very rare even in EBM reviews, then you derive the same conclusion. Its about effect sizes, and methodological problems in PACE and similar trials. Antivirals do better than CBT/GET overall. Yet they only apply to patients with high viral titres. Its a subgroup success. Rituximab looks to be another subgroup success. I suspect antibiotics might be too, but the literature appears weaker there.
 

TiredSam

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Here's a link to the article:

http://www.psychiatryadvisor.com/op...-in-chronic-fatigue-treatment/article/405424/

What has emerged from my work is that over 85% of patients with SEID (diagnosed by Fukuda criteria5) respond to antiviral therapy. Among adolescents, the outcome is better with 92% responding.
Eighty-six percent of the patients responded by 3 months, and 92% responded by 5 months. Symptoms of fatigue, exertion induced malaise, excessive sleep, napping, unrefreshing sleep, headaches, cognitive symptoms, and emotional symptoms all resolved.
Those seem like very bold claims. Still, very refreshing to read a psychiatrist who talks about ME in terms of physical illness and even criticises PACE.
 

Woolie

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Lately what's been bugging me a lot is the word 'fatigue'. What is fatigue?
Its funny, before I knew anything about this disease, I would never have described my primary symptom as fatigue.

Early on, a doctor once said that he was puzzled by my case, because my symptoms were so "non-specific". "You know, fatigue etc.".

"But I never said I felt fatigued", I replied. "I feel like I have a constant flu, acheing burning neck glands, crushing headache, constant feeling of being in a hot sweat, and often a sore throat like its been ripped out with sandpaper. Doesn't sound that nonspecific to me".

The doc replied, "But you also said you're stuck in bed most of the time. Why would you need to go to bed unless you were fatigued?"

He was a pretty decent doctor too. Argh!