The effectiveness of citalopram for idiopathic chronic fatigue

J Clin Psychiatry. 2003 Aug;64(8):927-35. doi: 10.4088/jcp.v64n0811.


Background: Chronic fatigue greatly affects quality of life and is a common reason for physician visits. Patients with chronic fatigue are often treated with antidepressants.

Method: Prior to enrollment, all subjects had substantial fatigue for 6 months or more that was not explained by depression, organic illness, or lifestyle behaviors. Patients already taking an antidepressant were excluded from the study. Two designs were used. (1) Thirty-one subjects were given placebo for 1 week and then citalopram, 20 to 40 mg/day, for 2 months. Statistical testing evaluated whether fatigue (measured with the Rand Vitality Index) was reduced after citalopram was started. (2) Fatigue changes for subjects taking citalopram were compared with fatigue changes after 1 month and 2 months for 76 similar subjects taking an ineffective treatment.

Results: In design 1, fatigue for subjects taking citalopram was significantly and substantially reduced when subjects were switched from placebo to citalopram, p <.05. Benefits at 2 months were greatest for subjects who had fatigue less than 5 years, p <.01, and women, p <.01. In design 2, fatigue scores for subjects taking citalopram were not significantly better than the comparison group for all subjects but were significantly better at 2 months for subjects with less severe fatigue at baseline, p =.005, and for women, p =.08. Depression scores were not significantly better for citalopram subjects overall (p >.10) but were for certain subgroups. For all subjects, citalopram was associated with greater decrease in headaches and muscle aches at 1 month, p <.01.

Conclusion: Citalopram may improve fatigue and symptoms associated with fatigue for some patients.

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Aged
  • Chronic Disease
  • Citalopram / therapeutic use*
  • Drug Administration Schedule
  • Fatigue / diagnosis
  • Fatigue / drug therapy*
  • Fatigue / psychology
  • Fatigue Syndrome, Chronic / diagnosis
  • Fatigue Syndrome, Chronic / drug therapy
  • Fatigue Syndrome, Chronic / psychology
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Patient Selection
  • Placebos
  • Psychiatric Status Rating Scales
  • Research Design
  • Serotonin Uptake Inhibitors / therapeutic use*
  • Severity of Illness Index
  • Treatment Outcome


  • Placebos
  • Serotonin Uptake Inhibitors
  • Citalopram