PMID- 24445302
OWN - NLM
STAT- MEDLINE
DCOM- 20140630
LR  - 20181203
IS  - 1532-1843 (Electronic)
IS  - 1470-3556 (Linking)
VI  - 28
IP  - 1
DP  - 2014 Winter
TI  - Valacyclovir treatment of chronic fatigue in adolescents.
PG  - 4-14
AB  - Chronic fatigue syndrome (CFS) presents with fatigue, low motivation, diminished 
      mood, and reduced activity, all symptoms having extensive diagnostic overlaps 
      with depression. Studies have linked chronic viral infections with CFS, and 
      antiviral therapy has effectively treated CFS in adult patients. In a 
      retrospective case series, 15 adolescents and preteens referred to the author for 
      treatment-resistant depression or mood disorder were evaluated and found to have 
      met the Fukuda diagnostic criteria for CFS. While a subset (4/15) had been 
      diagnosed in the past with CFS, the majority had a current diagnosis of 
      depression or a mood disorder. The Diagnostic and Statistical Manual-IV Text 
      Revision (DSM-IV TR) criteria for depression were not met in all patients, 
      although 3 cases of mood disorder not otherwise specified (MD-NOS) and 1 case of 
      Tourette syndrome (TS) plus MD-NOS were diagnosed. Baseline scores on the 
      Children's Depression Inventory (CDI) were below the cutoff for depression in all 
      but 1 patient. Baseline self-assessment scales for CFS or fatigue were obtained 
      and sleep was evaluated with sleep logs. All patients were treated subsequently 
      with valacyclovir, with 93% having a positive response. At the end of treatment, 
      scores on fatigue self-assessment scales improved significantly (P < .001). Vigor 
      subscale scores also improved significantly (P < .001). Some patients experienced 
      complete resolution of symptoms. Although not every patient was tested, available 
      laboratory testing revealed increased counts of natural killer (NK) cells and 
      decreased human herpesvirus 6 (HHV-6) antibody titers in all patients who 
      responded to valacyclovir. This article discusses the significance of infectious 
      agents in the pathogenesis of psychiatric symptoms. The study's data support an 
      intriguing hypothesis that a portion of treatment-resistant depression in fact 
      may be undiagnosed CFS or other chronic viral infection.
FAU - Henderson, Theodore A
AU  - Henderson TA
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Adv Mind Body Med
JT  - Advances in mind-body medicine
JID - 9813115
RN  - 0 (Antidepressive Agents)
RN  - 0 (Antiviral Agents)
RN  - HG18B9YRS7 (Valine)
RN  - MZ1IW7Q79D (Valacyclovir)
RN  - X4HES1O11F (Acyclovir)
SB  - IM
MH  - Acyclovir/adverse effects/*analogs & derivatives/therapeutic use
MH  - Adolescent
MH  - Antidepressive Agents/adverse effects/therapeutic use
MH  - Antiviral Agents/adverse effects/therapeutic use
MH  - Depressive Disorder, Treatment-Resistant/*drug therapy
MH  - Fatigue Syndrome, Chronic/*drug therapy
MH  - Female
MH  - Humans
MH  - Male
MH  - Retrospective Studies
MH  - Valacyclovir
MH  - Valine/adverse effects/*analogs & derivatives/therapeutic use
EDAT- 2014/01/22 06:00
MHDA- 2014/07/01 06:00
CRDT- 2014/01/22 06:00
PHST- 2014/01/22 06:00 [entrez]
PHST- 2014/01/22 06:00 [pubmed]
PHST- 2014/07/01 06:00 [medline]
PST - ppublish
SO  - Adv Mind Body Med. 2014 Winter;28(1):4-14.