Just waving at Cindy and Stephy......... they have all the right answers as they are living with this. YOU GO GIRLS! :-) Gave you both a thumbs up! Take care and thank you for always being so willing to help others. You ladies ROCK!
Also.... here's an older link:
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Docs Reveal Possible Therapy for HCV Fatigue
by John C. Martin
Article Date: 08-17-05
A small study from France suggests that a drug prescribed for people with chronic fatigue syndrome may also help patients who have chronic fatigue related to hepatitis C infection.1 The drug, marketed as Zofran (ondansetron), falls in a class of medications known as serotonin receptor antagonists.
How is the Drug Currently Used?
Zofran, available in either oral form or as an injectable, is mainly prescribed to ease nausea and vomiting associated with chemotherapy. It was approved for this indication in 1991. Previous to that, it was believed that chemotherapy-related nausea and vomiting was unpredictable and unavoidable.2
The drug is also prescribed to reduce nausea and vomiting related to certain outpatient surgeries. These side effects are among the most common causes of unplanned hospital admission after outpatient surgery, affecting as many as 80 percent of patients.3
Zofran Versus SSRIs for Chronic Fatigue
People with a condition known as chronic fatigue syndrome, characterized by never-ending tiredness, may be prescribed medications known as selective serotonin reuptake inhibitors (SSRIs), which help treat the depression associated with this condition.4 These drugs work by boosting levels of a neurotransmitter in the brain known as serotonin. Serotonin helps neurons transmit impulses to each other in the brain, which in turn, improves mood, and has helped ease the fatigue associated with depression.5
Still, some medical researchers have tested Zofran and similar serotonin receptor antagonists, as a therapy for chronic fatigue syndrome, as well, which work in the opposite way as SSRIs by blocking the activity of serotonin in the central nervous system.6,7 Experts suggest that serotonin plays a key role in chronic fatigue.8
A 'Disabling' Hepatitis Symptom
In the wake of positive research testing drugs in the same class as Zofran for chronic fatigue,6 doctors at Hopital Archet in Nice, France enrolled 18 patients in their study to see if the drug would work for hepatitis C-related fatigue. Fatigue associated with the disease is not only common, but "disabling", the researchers pointed out.9 "Considering the high prevalence of fatigue, thus constituting a considerable burden for the health care system … the development of effective therapies for its relief may be important goals for research in Hepatogastroenterology," they wrote.
This persistent fatigue, they write, is not only the most common symptom in primary care, but renders people who have it unable to perform daily routines, significantly reducing their quality of life. But, one of the main roadblocks to finding an effective therapy is the fact that relatively little is known about its origins, the researchers stress.
Testing Zofran Versus No Treatment
The French research team launched this small clinical trial in hopes of finding more answers. Each patient who enrolled was assigned at random to a group receiving 4 mg of Zofran twice each day, or a group receiving a placebo, an intervention used as a comparison in clinical trials that have no therapeutic effectiveness. Nearly all the patients considered fatigue their most significant symptom of the disease, and nearly two-thirds considered it their worst, the researchers noted. Neither the patients nor the clinicians in the study knew who was taking Zofran, and who was not, to eliminate any possible bias. One potential side effect of the medication is constipation, but patients were treated using a laxative, if necessary.
The trial lasted four weeks. During that time, levels of fatigue and depression were measured regularly using questionnaires completed by each patient. After one month of treatment, the patients then underwent observation four weeks afterwards.
Promising Findings
The investigators found that, based on the patients' questionnaires, fatigue was reduced by nearly a third in the group given Zofran compared to the patients taking a placebo. Those in the latter group saw their fatigue diminish, but no more than 30% for the entire study. At the follow-up 60 days after the study began, the patients in the placebo group reported their fatigue had dropped less than 6%, on average. In contrast, during this same follow-up, fatigue was reduced by about 31% in the treatment group, the French research team reported.
"Overall, the reduction in fatigue was significantly higher with ondansetron compared with placebo for the whole follow-up period or the treatment period only," the study team wrote. "Ondansetron also significantly reduced depression scores." By the time patients were examined one month after the study ended, depression had eased by nearly 42%, on average, in the group given Zofran, compared to just a 5.8% decline in the group that had received a placebo.
Despite about 38 percent of the patients experiencing constipation as a treatment side effect, the researchers concluded that Zofran provided "a positive effect", while stressing that larger trials of the drug should be performed.
Still Few Answers, but Therapy Appears Promising
In a commentary on the trial,10 Dr. Nicholas Barnes, a neuropharmacologist at the University of Birmingham in the UK, wrote that there are still many elusive answers about the nature and origins of chronic fatigue. "Despite a high prevalence with massive socioeconomic implications, fatigue per se, or as a symptom of a diagnosed condition, remains poorly understood," Barnes wrote. Further, since fatigue is a key symptom in people with clinical depression, "it would be pertinent" to determine whether medications like Zofran can ease both depression and the fatigue associated with it, he added.
In concurring with the French researchers who published this study, Barnes stresses that growing evidence of the benefit of serotonin receptor antagonists for chronic fatigue "requires support from large multicenter trials."
1. Piche T, Vanbiervliet G, Cherikh F et al. Effect of ondansetron, a 5-HT3 receptor antagonist, on fatigue in chronic hepatitis C: a randomized, double blind, placebo controlled study. Gut 2005 Aug;54(8):1169-73.
2. GlaxoSmithKline. Zofran can help you and your healthcare professional prevent nausea and vomiting. Available at: http://www.zofran.com. Accessed August 11, 2005.
3. GlaxoSmithKline. Nausea and vomiting caused by surgery are very common. Available at: http://www.zofran.com/surgery/surgerymain.html. Accessed August 11, 2005.
4. Mayo Foundation for Medical Education and Research. Chronic Fatigue Syndrome. Available at: http://www.mayoclinic.com/invoke.cfm?objectid=A026FC79-096B-4920-AA54503DE4B22308&dsection=8. Accessed: August 11, 2005.
5. Mayo Foundation for Medical Education and Research. Selective serotonin reuptake inhibitors (SSRIs). Available at: http://www.mayoclinic.com/invoke.cfm?id=MH00066. Accessed August 11, 2005.
6. The GK, Prins J, Bleijenberg G, van der Meer JW. The effect of granisetron, a 5-HT3 receptor antagonist, in the treatment of chronic fatigue syndrome patients—a pilot study. Neth J Med 2003 Sep;61(9):285-9.
7. National Cancer Institute. Nausea and Vomiting. Treatment of Acute/Delayed Emesis. Available at: http://www.nci.nih.gov/cancertopics/pdq/supportivecare/
nausea/HealthProfessional/page6. Accessed August 17, 2005.
8. Sharpe M, Hawton K, Clements A, Cowen PJ. Increased brain serotonin function in men with chronic fatigue syndrome. BMJ 1997 Jul l19;315(7101):164-5.
9. Piche T, Huet PM, Tran A. Treatment of fatigue in Gastroenterology: fact or fiction? Gastroenterol Clin Biol 2005 May;29(5):561-3.
10. Barnes NM. 5-HT3 receptor antagonists ameliorate fatigue: so much potential, so little knowledge! Gut 2005 Aug;54(8):1056-7.
John Martin is a long-time health journalist and an editor for Priority Healthcare. His credits include overseeing health news coverage for the website of Fox Television's The Health Network, and articles for the New York Post and other consumer and trade publications.
http://www.hepatitisneighborhood.com/content/in_the_news/archive_2471.aspx