Wearden, A J, Morriss, R K, Mullis, R et al. · The British journal of psychiatry : the journal of mental science · 1998 · DOI
This study tested whether graded exercise and/or a antidepressant medication called fluoxetine could help people with ME/CFS. Researchers randomly assigned 136 patients to receive either exercise, medication, both, or neither over 6 months. Exercise showed modest benefits for fatigue and physical function, while the medication only helped with depression symptoms, and many patients found it difficult to stick with the exercise program.
This is one of the earlier rigorous randomised controlled trials examining recommended first-line treatments (GET and antidepressants) for ME/CFS, providing empirical evidence about their relative efficacy and tolerability. Understanding which treatments produce meaningful functional improvements versus symptom management is critical for clinical decision-making and patient counselling.
This study does not prove that GET is universally beneficial or safe for all ME/CFS patients, as it does not stratify by baseline severity or post-exertional malaise severity, and high dropout rates suggest the intervention may be poorly tolerated by some. It does not establish that fluoxetine is ineffective overall, only that its benefits were limited to depression at one timepoint. The study does not address whether patients experienced harms or worsening symptoms during or after the intervention.
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
Wearden, A J, Morriss, R K, Mullis, R, Strickland, P L, Pearson, D J, Appleby, L, et al. (1998). Randomised, double-blind, placebo-controlled treatment trial of fluoxetine and graded exercise for chronic fatigue syndrome.. The British journal of psychiatry : the journal of mental science. https://doi.org/10.1192/bjp.172.6.485
BibTeX
@article{mecfsatlas-wearden-1998-randomised-double,
author = {Wearden, A J and Morriss, R K and Mullis, R and Strickland, P L and Pearson, D J and Appleby, L and Campbell, I T and Morris, J A},
title = {Randomised, double-blind, placebo-controlled treatment trial of fluoxetine and graded exercise for chronic fatigue syndrome.},
journal = {The British journal of psychiatry : the journal of mental science},
year = {1998},
doi = {10.1192/bjp.172.6.485},
note = {PubMed: 9828987},
url = {https://www.mecfsatlas.com/evidence/wearden-1998-randomised-double},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-25. https://www.mecfsatlas.com/evidence/wearden-1998-randomised-double
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