There may be an overlap with treatments for depression and fatigue in chronic fatigue syndrome. There can also be a strong correlation between fatigue and depression (CFS) but evidence as to whether this correlation is causal or simply correlational or both is limited.
The major signs and symptoms of fatigue are related to the underlying cause of fatigue, not the medical term for “fatigue”. However, the medical term “fatigue” is still commonly used. The following are some of the major signs/symptoms that are associated with fatigue.\n- Persistent fatigue can be a major symptom of depression or a side effect of certain medications such as selective serotonin re-uptake inhibitors (SSRIs) and monoamine oxidase inhibitors (MAOIs).\n- Cognitive impairment, which could include difficulty with memory, attention, planning, or reasoning, may persist in depression. Furthermore, depression is often associated with cognitive impairment.
In terms of reduction from baseline fatigue scores, the best reduction is achieved using nonopioid medications, and this effect is maintained over time. In patients with low initial baseline fatigue scores, fatigue reduction can also be achieved with opioid medications, but this reduction is not maintained in the long term.
A diagnosis of CFS seems to be associated with both high levels of fatigue (vitamin B12 serum values < 190 pg/ml) and high levels of fatigue (self-reported by the patient) during the past year. Data from a recent study is limited by a small number of subjects, but these results suggest that levels of vitamin B12 and self-reported levels of fatigue may be complementary and helpful tools, in the diagnosis of CFS in addition to other criteria, for determining both the severity and the phenotype of the illness.
Although the pathophysiology of fatigue continues to be debated, a vast majority of studies have reported a reduced aerobic capacity or a high metabolic and muscular sympathetic nervous system activity in fatigued subjects. The reduction of aerobic capacity may exacerbate the exhaustion of a workload in subjects with fatigue.
About 10% of adults in the United States say they 'often feel tired.' This is more common in adult males, with the exception of college graduates. The most common reasons for fatigue included insufficient sleep and physical activity. Subjective fatigue impacts a higher percentage of working adults than objective fatigue or depression symptoms, and is associated with poorer daily functioning.
The data presented here have been reported on in hundreds of published [research articles] which indicate that the data presented are valid and generalizable, being similar to studies of other groups (i.e. age, gender, etc.). However, it is important to note the differences inherent in any sample, since some groups are more likely to experience fatigue than others. It is also possible that some groups could, in fact, produce more fatigue from the tests (i.e. those who have worked for longer hours in the past months, or have a higher body temperature).
Most patients were not interested in enrolling in clinical trials of treatments to relieve fatigue. There was little interest by patients who were older than 75 years. More than 90% of patients did not think it was necessary to enroll in a clinical trial for fatigue if their disease was mild but only 20% of respondents said they were willing to enroll in a trial with a moderate level of fatigue.
Subjects receiving placebo and subjects on the armodafinil dose experienced a mean change on the SF-36 physical function domain of 7.3 (6.0-7.9) and 6.6 (4.7-7.8) points and a mean change on the QoL interference with activities domain of 7 (5.5-9) and 6.5 (4.5-7.3) points, respectively, with armodafinil subjects. In addition, in the armodafinil group, 2 of 30 patients reported an improvement in QoL.
Armodafinil has a well balanced tolerability profile, which is particularly supportive of its potential for use in the elderly. Results from a recent clinical trial imply that armodafinil could be a desirable drug for sleep-related disorders in the elderly. This trial was registered at www.anzctr.org.au as ACTRN12606300022536.
Primary-cause fatigue was found to be the most common symptom in patients with CFS. This suggests that in addition to a primary neurophysiological dysfunction, there may be a predisposing psychiatric component with regard to primary-cause fatigue.