Arnold, Lesley M, Blom, Thomas J, Welge, Jeffrey A et al. · Psychosomatics · 2015 · DOI
This study tested whether duloxetine, a medication that affects mood and pain, could help reduce fatigue in people with ME/CFS. Over 12 weeks, 60 patients either took duloxetine or a placebo (dummy pill). While the medication did not significantly improve general fatigue compared to placebo, it did help some people with mental fatigue, pain, and overall symptom severity.
This study addresses an important clinical question about whether serotonin-norepinephrine reuptake inhibitors can ameliorate ME/CFS fatigue and comorbid symptoms. The mixed results—negative for primary outcome but positive for pain and secondary fatigue measures—help clarify which symptom domains may respond to duloxetine and inform treatment discussions between patients and clinicians.
This study does not prove that duloxetine is ineffective for ME/CFS, only that it did not significantly improve general fatigue in this 12-week trial. The improvement in secondary measures does not establish that these benefits meaningfully improve daily function or quality of life. The sample size (n=60) and single dosing range limit generalizability to different patient populations or dosing strategies.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
The first block is for the primary paper and is the citation you should use in research work. The atlas-snapshot line only applies if you are specifically referring to this atlas’s reading of the paper on the date shown.
Primary citation
Arnold, Lesley M, Blom, Thomas J, Welge, Jeffrey A, Mariutto, Elizabeth, & Heller, Alicia (2015). A randomized, placebo-controlled, double-blinded trial of duloxetine in the treatment of general fatigue in patients with chronic fatigue syndrome.. Psychosomatics. https://doi.org/10.1016/j.psym.2014.12.003
BibTeX
@article{mecfsatlas-arnold-2015-randomized-placebo,
author = {Arnold, Lesley M and Blom, Thomas J and Welge, Jeffrey A and Mariutto, Elizabeth and Heller, Alicia},
title = {A randomized, placebo-controlled, double-blinded trial of duloxetine in the treatment of general fatigue in patients with chronic fatigue syndrome.},
journal = {Psychosomatics},
year = {2015},
doi = {10.1016/j.psym.2014.12.003},
note = {PubMed: 25660434},
url = {https://www.mecfsatlas.com/evidence/arnold-2015-randomized-placebo},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-30. https://www.mecfsatlas.com/evidence/arnold-2015-randomized-placebo
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