1998 Clinical and Scientific Meeting

C G.Gottfries M.D.D.PH

Institute of Clinical Neuorscience
Department of Psychiatry and Neurochemistry
University of Goteborg

Effects Of Staphylococcus Toxoid In Patients With Fibromyalgia And CFS

In 1958 and 1959 there was an epidemic of an influenza virus (Asian Flu) in Sweden. Quite a lot of patients came to the psychiatric ambulatory service a couple of months after the infection complaining over "psychiatric" symptoms including severe fatigue, concentration difficulties, irritability and depression. Assuming secondary infections trials were made treating those patients with antibiotics which proved to be of little use. Treatment with staphylococcus toxoid in pilot studies was of benefit for the patients.

In 1991 a new pilot study was made in 8 patients who fulfilled the criteria for both fibromyalgia and chronic fatigue syndrome The patients were treated for 12 weeks with increasing doses of Staphypan Berna from the Swiss Serum and Vaccine Institute and the effect was evaluated with rating scales. All 8 patients improved and 5 of them are still, after 5-6 years, on continuos treatment with an injection of the toxoid every 4th-6th week.

A controlled study was performed 1995 where the staphylococcus toxid was compared with distilled water according to the double blind technique in 28 patients all of them fulfilling the criteria for both fibromyalgia and chronic fatigue syndrome. The effect was evaluated with the Clinica1 Global Impression of Change (CGIC) scale, the Comprehensive Psychopathological Rating scale (CPRS-15), and Zungs Selfrating Depression scale. The Visual Analogue Scale (VAS) was used to measure pain levels and a hand held electronic pressure algometer was used to measure pressure pain thresholds.

Significant improvement was seen after 12 weeks treatment with increasing doses of the toxoid in the active treated group (n=13) in seven of the 15 CPRS items. In CPRS "fatiguability" there was significant intergroup difference, and in CPRS "pain" there was intergroup differences that borders on significance. CGIC showed significant improvement in the group treated with the toxoid. In a follow up study including 23 patients active treatment with staphylococcus toxoid was given for 2-6 years. Twelve of these patients were successfully rehabilitated to work.


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