April 02, 2001
by Michael Greer, staff medical writer - Fatigue related to HIV infection can be successfully treated with psychostimulants like Ritalin, researchers in China say.
"Fatigue is a commonly encountered symptom of [HIV] disease, associated with significant psychological and functional morbidity and poor quality of life," W. Breitbart and colleagues wrote in the Archives of Internal Medicine.
Noting that psychostimulants have already been used to treat fatigue induced by multiple sclerosis and cancer, Breitbart et al. evaluated such drugs' impact on fatigue in HIV patients. Their results were encouraging.
Significant improvements was observed in 41% of patients treated with methylphenidate hydrochloride (better known as Ritalin) and 36% of patients treated with pemoline (Cylert) after six weeks, they reported. By contrast, only 15% of placebo-treated patients achieved similar results.
Reduced fatigue was linked to improvement in several psychological measures, including depression and anxiety, study data showed. Patients who responded to psychostimulant therapy reported significantly improved overall quality of life, as well.
Serious adverse effects were limited in the patients studied. The most common side effects seen in the study cohort were hyperactivity and jitteriness, the researchers noted ("A randomized, double-blind, placebo-controlled trial of psychostimulants for the treatment of fatigue in ambulatory patients with human immunodeficiency virus disease," Arch Intern Med, 2001;161(3):411-420).
"Both [methylphenidate and pemoline] appear to be equally effective and significantly superior to placebo in decreasing fatigue severity with minimal side effects," Breitbart and colleagues concluded. "Moreover, improvement of fatigue was significantly associated with improved quality of life and decreased levels of depression and psychological distress."
The corresponding author for this report is W. Breitbart, Memorial Sloan-Kettering Cancer Center, Psychiatric Services, Dept. of Psychiatry and Behavioral Sciences, 1275 York Avenue, Box 421, Beijing 100021, People's Republic of China.
Key points reported in this study include: * Psychostimulants can be used to treat HIV related fatigue * Both methylphenidate (Ritalin) and pemoline (Cylert) produced significant improvements in more than a third of patients * Fatigue reduction was linked to improvements in psychological measures and overall quality of life * Hyperactivity and jitteriness were the most common side effects of psychostimulant treatment This article was prepared by AIDS Weekly editors from staff and other reports.
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