Pharmacopsychiatry 2006; 39(4): 152-154
DOI: 10.1055/s-2006-946706
Letter
© Georg Thieme Verlag KG Stuttgart · New York

Bupropion Augmentation in the Treatment of Chronic Fatigue Syndrome with Coexistent Major Depression Episode

A Case ReportC. Schönfeldt-Lecuona1 , B. J. Connemann1 , R. C. Wolf1 , M. Braun1 , R. W. Freudenmann1
  • 1University of Ulm, Department of Psychiatry, Leimgrubenweg 12 - 14, 89075 Ulm, Germany
Further Information

Publication History

Received: 16.1.2006 Revised: 2.3.2006

Accepted: 13.3.2006

Publication Date:
27 July 2006 (online)

While psychoeducational strategies and general support are always indicated for the treatment of chronic fatigue syndrome (CFS), pharmacological strategies are yet not well established. Antidepressants such as selective serotonin re-uptake inhibitors have been shown to influence positively symptoms and immunological parameters. However, a considerable part of CFS patients do not satisfactorily respond to them. Bupropion, a centrally acting catecholamine-transporter blocker without classic psycho-analeptic properties, shows theoretical potential to improve fatigue symptoms. In the reported case paroxetine was augmented with bupropion at high dosage, a strategy which consecutively led to a rapid relief of CFS-symptoms.

References

  • 1 Ascher J A, Cole J O, Colin J N, Feighner J P, Ferris R M, Fibiger H C. et al . Bupropion: a review of its mechanism of antidepressant activity.  J Clin Psychiatry. 1995;  56 395-401
  • 2 Bruera E, Driver L, Barnes E A, Willey J, Shen L, Palmer J L. et al . Patient-controlled methylphenidate for the management of fatigue in patients with advanced cancer: a preliminary report.  J Clin Oncol. 2003;  21 4439-4443
  • 3 Carruthers B M, Jain A K, De Meirleir K L, Peterson D L, Klimas N G, Lerner A M. et al . ME/CFS: clinical working case definition, diagnostic and treatment protocols.  J Chron Fatigue Syndrome. 2003;  11 1-97
  • 4 Cleare A J, Messa C, Rabiner E A, Grasby P M. Brain 5-HT1A receptor binding in chronic fatigue syndrome measured using positron emission tomography and [11C]WAY-100 635.  Biol Psychiatry. 2005;  57 239-246
  • 5 Craig T, Kakumanu S. Chronic fatigue syndrome: evaluation and treatment.  Am Fam Physician. 2002;  65 1083-1090
  • 6 Cullum J L, Wojciechowski A E, Pelletier G, Simpson J S. Bupropion sustained release treatment reduces fatigue in cancer patients.  Can J Psychiatry. 2004;  49 139-144
  • 7 Fishbain D A, Cutler R B, Lewis J, Cole B, Rosomoff H L, Steele-Rosomoff R. Modafinil for the treatment of pain-associated fatigue: review and case report.  J Pain Palliat Care Pharmacother. 2004;  18 39-47
  • 8 Fukuda K, Straus S E, Hickie I, Sharpe M C, Dobbins J G, Komaroff A. The chronic fatigue syndrome: a comprehensive approach to its definition and study. International Chronic Fatigue Syndrome Study Group.  Ann Intern Med. 1994;  121 953-959
  • 9 Goodnick P J, Sandoval R. Psychotropic treatment of chronic fatigue syndrome and related disorders.  J Clin Psychiatry. 1993;  54 13-20
  • 10 Goodnick P J, Sandoval R, Brickman A, Klimas N G. Bupropion treatment of fluoxetine-resistant chronic fatigue syndrome.  Biol Psychiatry. 1992;  32 834-838
  • 11 Holmes G P, Kaplan J E, Gantz N M, Komaroff A L, Schonberger L B, Straus S E. et al . Chronic fatigue syndrome: a working case definition.  Ann Intern Med. 1988;  108 387-389
  • 12 Sharpe M C, Archard L C, Banatvala J E, Borysiewicz L K, Clare A W, David A. et al . A report-chronic fatigue syndrome: guidelines for research.  J R Soc Med. 1991;  84 118-121
  • 13 Steele L, Dobbins J G, Fukuda K, Reyes M, Randall B, Koppelman M. et al . The epidemiology of chronic fatigue in San Francisco.  Am J Med. 1998;  105 (3A) 83S-90S
  • 14 Turkington D, Hedwat D, Rider I, Young A H. Recovery from chronic fatigue syndrome with modafinil.  Hum Psychopharmacol. 2004;  19 63-64

Dr. med. Carlos Schönfeldt-Lecuona, MD

University of Ulm

Dep. of Psychiatry III

Leimgrubenweg 12-14

89075 Ulm

Germany

Phone: +49 731 500 21499

Fax: +49 731 500 26751

Email: carlos.schoenfeldt@uni-ulm.de