Lloyd, A R, Hickie, I, Brockman, A et al. · The American journal of medicine · 1993 · DOI
This study tested whether two treatments—an immune-boosting extract and cognitive-behavioral therapy (a talk therapy focused on thoughts and behaviors)—could help people with ME/CFS. Ninety patients received either these treatments, a placebo, or combinations of both in a blinded trial. Neither treatment worked better than placebo, suggesting that the improvement some patients experienced may have been due to placebo effect or natural recovery rather than the specific treatments tested.
This rigorous, high-quality trial addresses whether two plausible ME/CFS treatments—immunologic intervention and behavioral therapy—are actually effective, providing important evidence against their specific benefit. The findings help redirect research focus and prevent ineffective treatments from becoming standard practice, ultimately improving how ME/CFS treatment is approached.
This study does not prove that CBT or immune-modulating therapies are never helpful for any ME/CFS patients; it shows they were not superior to placebo in this particular trial population and timeframe. The negative findings do not explain the biological mechanisms of ME/CFS or rule out other potential treatments. The study also does not establish whether different patient subgroups, dosages, or treatment durations might show different responses.
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 →
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