Complementary and alternative medicine treatments in the management of chronic fatigue syndrome: a systematic review of randomized controlled trials

Abstract

Chronic fatigue greatly deteriorates the quality of life and is a frequent reason for consulting a physician. Since conventional medicine usually provides limited help, patients with chronic fatigue syndrome (CFS) tend to use complementary and alternative medicines (CAM). The objective of this review was to summarize the evidence of the effectiveness of CAM treatments in the management of CFS. Electronic databases were systematically searched up to December 2010. All randomized controlled trials (RCTs) of CAM used in patients with CFS were considered for inclusion if they included placebo controls or were controlled against a comparator intervention. Methodology quality was assessed using modified Jadad score and the Cochrane criteria for allocation concealment. A total of 414 possibly relevant articles were identified, of which eight RCTs met our inclusion criteria: three dietary interventions, two herbal medicines, one distant healing, one homeopathic medicine, and one massage. The methodology quality of the trials varied, and on average, was moderate (mean Jadad score, 3.625; range, 0–5). Details on allocation concealment were reported for seven of the trials, of which six were classified as adequate. Of the eight included RCTs, three reported significant differences between the treatment and placebo groups in the primary outcome measures. However, the total number of RCTs included in the analysis was too small to provide definite evidence for the effectiveness of CAM in treating CFS. More RCTs on the effectiveness of CAM in the management of CFS should be conducted with larger patient samples, longer treatment periods, and appropriate methodology.