Dr Le Fanu is the Daily Telegraph's doctor. These comments appeared in his ‘Doctor's Diary' on 20 May 2103.
The debilitating chronic fatigue syndrome/encephalomyeltis (CFS/ME) is prevalent in children and adolescents. This emerged from an investigation a couple of years ago into prolonged school absence (one fifth or more of the school term) in 500 pupils attending secondary schools in Bath, which identified 23 children with the condition.
This is the more surprising because its characteristics are so striking – starting with a flu-like viral illness, followed by muscle and joint pains, unrefreshing sleep, headaches and difficulty in concentration that can persist for years. Treatment remains unsatisfactory, as the organiser of the study, Dr Esther Crawley of Bristol University, concedes. The standard regime of graded exercises and cognitive behaviural therapy is only “moderately effective”.
Dr David Smith, who has treated 4,000 children with CFS/ME over the past 20 years, advocates a different approach, including a low dose of Fluoxetine to correct the disorder of brain function. He recently retired, and his comprehensive “Getting Better Regime” can be found on his website (www.me-cfs-treatment.com).
Paremts' difficulty in obtaining treatment is explored in the film Voices from the Shadows, available as a DVD from www.voicesfromtheshadowsfilm.co.uk
Some of us parents did discuss the first study mentioned here at that time (Dec. 2011).
Study at – http://www.bmjopen.bmj.com/cgi/collection/bmj_open_paediatrics
NHS choices reviewed the study too –
http://www.nhs.uk/news/2011/12december/pages/me-cfs-cause-of-school-absence.aspx
The ‘NHS choices’ review said – the actual ‘treatment’ each of the 19 received was not described in detail. Nor the level of fatigue plus other symptoms of each at the outset. The research states the Nice Guideline CFS/ME of definition was used (fatigue and 1 other symptom).
We were curious as to what level and what happened to the 6 (of 19) with whom there was no diffference after 6 months. And what happened with the 4 (of the 23) who were newly dignosed with CFS/ME but who chose not to attend the specialist service & take up the described treatment available?
Oh perlease! Don’t perpetuate the myth that SSRIs have any but a negative role to play in the majority of normal people, let alone those with M.E!
Anti depressants! Of course! Good grief. Once again the square wheel has just been re invented – this time by James Le Fanu.
Dr Smith’s theory about using both SSRIs and tricyclics is ancient. There is no genuine scientific basis to his theory and combining these drugs is contra-indicated.
I know he says it’s just in small doses, and they’re timed to be far apart from each other; I know he says they’re not being used as antidepressants, but just to “stimulate the brain into working properly” but given nobody knows how SSRIs work or what the troubles PWME have with *all* drugs at all tiny doses, I reckon this should be avoided. Seriously avoided.