While no clinical trial to date has specifically targeted fatigue , r and omized controlled trials , systematic review s , and meta-analyses indicate that treatment modalities studied in the context of other fibromyalgia symptoms could also improve fatigue .
Fatigue is a disabling , multifaceted symptom that is highly prevalent and stubbornly persistent .
Although fatigue is a frequent complaint among patients with fibromyalgia , it has not received the same attention as pain .
Reasons for this include lack of st and ardized nomenclature to communicate about fatigue , lack of evidence -based guidelines for fatigue assessment , and a deficiency in effective treatment strategies .
Fatigue does not occur in isolation ; rather , it is present concurrently in varying severity with other fibromyalgia symptoms such as chronic widespread pain , unrefreshing sleep , anxiety , depression , cognitive difficulties , and so on .
Survey-based and preliminary mechanistic studies indicate that multiple symptoms feed into fatigue and it may be associated with a variety of physiological mechanisms .
Electroconvulsive therapy in patients with depression and fibromyalgia
The effect of electroconvulsive therapy ( ECT ) on depression and other symptoms of fibromyalgia was studied in a prospect i ve 3‐month trial in 13 patients with fibromyalgia and concomitant depression . All the patients met the DSM‐IV diagnostic criteria for Major Depressive Disorder and fulfilled the American College of Rheumatology diagnostic criteria for fibromyalgia . The Montgomery and Åsberg Depression Rating Scale ( MADRS ) and the clinical global impression scale ( CGI ) were used to assess the severity of depression and the clinical change of the patients . The fibromyalgia impact question naire ( FIQ ) was used to evaluate the severity of the fibromyalgia symptoms . The intensity of pain was evaluated using a 6‐point scale ( 0=no pain , 5=very severe pain ) , and tender point palpation . All assessment s were performed at baseline and at follow‐up visits , which took place one week , one month and three months after ECT . There was a significant improvement in depression  after ECT  according to MADRS . Using CGI , six patients were much or very much improved , while four patients were minimally improved and three patients had no change . There was significant improvement in four out of ten FIQ item scores , “ feel good ” , “ fatigue ” , “ anxiety ” and “ depression ” . No significant change was found in the FIQ item scores “ physical function ” , “ pain ” , “ stiffness ” and “ morning tiredness ” or number of tender points and self‐reported pain . We conclude that ECT is a safe and effective treatment for depression in fibromyalgia patients , but has no effect on the pain or other physical symptoms of these patients
While no clinical trial to date has specifically targeted fatigue , r and omized controlled trials , systematic review s , and meta-analyses indicate that treatment modalities studied in the context of other fibromyalgia symptoms could also improve fatigue .
Fatigue is a disabling , multifaceted symptom that is highly prevalent and stubbornly persistent .
Although fatigue is a frequent complaint among patients with fibromyalgia , it has not received the same attention as pain .
Reasons for this include lack of st and ardized nomenclature to communicate about fatigue , lack of evidence -based guidelines for fatigue assessment , and a deficiency in effective treatment strategies .
Fatigue does not occur in isolation ; rather , it is present concurrently in varying severity with other fibromyalgia symptoms such as chronic widespread pain , unrefreshing sleep , anxiety , depression , cognitive difficulties , and so on .
Survey-based and preliminary mechanistic studies indicate that multiple symptoms feed into fatigue and it may be associated with a variety of physiological mechanisms .