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Melatonin, Phototherapy Ineffective in Chronic Fatigue Syndrome

Researchers in the United Kingdom say that both melatonin and bright-light phototherapy appear ineffective in treating chronic fatigue syndrome (CFS).

"Their unregulated use should be prohibited unless, or until, clear benefits are convincingly demonstrated," say investigators from University Hospital Aintree and John Moores University, both in Liverpool, and the University of Manchester.

The researchers examined 30 patients with unexplained fatigue lasting more than six months.

Patients were first given placebo, and then were assigned to 5 milligrams of melatonin in the evening and phototherapy at 2,500 Lux for one hour in the morning. Each therapy was used for 12 weeks and was assigned in random order. There was a washout period between therapies.

Principal CFS symptoms were assessed using visual analogue scales, the Short Form Health Survey (SF-36), Mental Fatigue Inventory and Hospital Anxiety and Depression Scale.

The researchers determined participants' circadian rhythm of body temperature, timing of the onset of melatonin secretion and the relationship between the two factors.

"Neither intervention showed any significant effect on any of the principal symptoms or on general measures of physical or mental health," they report.

Body temperature rhythm and melatonin secretion were not significantly altered by either treatment in comparison to placebo. There was a slight advance of temperature phase with phototherapy, the investigators add.
European Journal of Clinical Investigation, 2002; 32: 831-837. "Therapy of circadian rhythm disorders in chronic fatigue syndrome: no symptomatic improvement with melatonin or phototherapy."

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