Blacker, C V Russell, Greenwood, David T, Wesnes, Keith A et al. · JAMA · 2004 · DOI
Researchers tested whether a medication called galantamine hydrobromide could help people with ME/CFS by comparing it to a placebo (dummy pill) in 434 patients across multiple countries. After 16 weeks of treatment, the medication did not work better than placebo for relieving fatigue, sleep problems, pain, or overall quality of life. This study shows that galantamine is not an effective treatment for ME/CFS.
This well-designed trial provides important negative evidence that galantamine—despite theoretical pharmacological rationale—does not benefit ME/CFS patients, helping redirect research away from ineffective treatments and toward more promising therapeutic targets. The study's rigorous methodology and large sample size offer reliable guidance for both clinicians and patients considering medication options for ME/CFS.
This study does not prove that no pharmacological treatment for ME/CFS exists, only that galantamine specifically is ineffective. It also does not establish whether other acetylcholine-modulating drugs might be beneficial, nor does it explain why theoretical properties of galantamine failed to translate into clinical benefit. The negative result in this population does not rule out potential benefits in ME/CFS subgroups not adequately represented in this trial.
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
Blacker, C V Russell, Greenwood, David T, Wesnes, Keith A, Wilson, Rosamund, Woodward, Carol, Howe, Ian, et al. (2004). Effect of galantamine hydrobromide in chronic fatigue syndrome: a randomized controlled trial.. JAMA. https://doi.org/10.1001/jama.292.10.1195
BibTeX
@article{mecfsatlas-blacker-2004-effect-galantamine,
author = {Blacker, C V Russell and Greenwood, David T and Wesnes, Keith A and Wilson, Rosamund and Woodward, Carol and Howe, Ian and Ali, Tauhid},
title = {Effect of galantamine hydrobromide in chronic fatigue syndrome: a randomized controlled trial.},
journal = {JAMA},
year = {2004},
doi = {10.1001/jama.292.10.1195},
note = {PubMed: 15353532},
url = {https://www.mecfsatlas.com/evidence/blacker-2004-effect-galantamine},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-26. https://www.mecfsatlas.com/evidence/blacker-2004-effect-galantamine
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