Table 11Clinical evidence summary: Central antihypertensive drugs (clonidine) versus placebo for ME/CFS

OutcomesNo of Participants (studies*) Follow upQuality of the evidence (GRADE)Relative effect (95% CI)Anticipated absolute effects
Risk with ControlRisk difference with Central antihypertensive drugs (clonidine) versus placebo (95% CI)
Cognitive function: Stockings of Cambridge - minimum moves

18

(1 study) 30

minutes

⊕⊝⊝⊝

VERY LOW1,2,3

due to risk of bias, indirectness, imprecision

The mean cognitive function: stockings of cambridge - minimum moves at 30 minutes in the control groups was

10.22

The mean cognitive function: stockings of cambridge - minimum moves at 30 minutes in the intervention group was

1.22 lower

(3.33 lower to 0.89 higher)

Cognitive function: Stockings of Cambridge - initial think time (secs)

18

(1 study)

30 minutes

⊕⊝⊝⊝

VERY LOW1,2,3

due to risk of bias, indirectness, imprecision

The mean cognitive function: stockings of cambridge - initial think time (secs) at 30 minutes in the control groups was

9.27

The mean cognitive function: stockings of cambridge - initial think time (secs) at 30 minutes in the intervention group (clonidine) was

1.28 lower

(5.19 lower to 2.63 higher)

Cognitive function: Stockings of Cambridge - subsequent thinking time (secs)

18

(1 study)

30 minutes

⊕⊝⊝⊝

VERY LOW1,2,3

due to risk of bias, indirectness, imprecision

The mean cognitive function: stockings of cambridge - subsequent thinking time (secs) at 30 minutes in the control groups was

1.89

The mean cognitive function: stockings of cambridge - subsequent thinking time (secs) at 30 minutes in the intervention group was

0.51 lower

(3.08 lower to 2.06 higher)

Cognitive function: Rapid Visual Information Processing - reaction time (secs)

18

(1 study)

30 minutes

⊕⊝⊝⊝

VERY LOW1,2,3

due to risk of bias, indirectness, imprecision

The mean cognitive function: rapid visual information processing - reaction time (secs) at 30 minutes in the control groups was

5.15

The mean cognitive function: rapid visual information processing - reaction time (secs) at 30 minutes in the intervention group (clonidine) was

0.15 lower

(1.42 lower to 1.12 higher)

Cognitive function: Intradimensional (IDS) set sift errors

18

(1 study)

30 minutes

⊕⊝⊝⊝

VERY LOW1,2,3

due to risk of bias, indirectness, imprecision

The mean cognitive function: intradimensional (ids) set sift errors at 30 minutes in the control groups was

0.22

The mean cognitive function: intradimensional (ids) set sift errors at 30 minutes in the intervention group was

0.22 higher

(0.34 lower to 0.78 higher)

Cognitive function: Extradimensional (EDS) set shift errors

18

(1 study)

30 minutes

⊕⊝⊝⊝

VERY LOW1,2,3

due to risk of bias, indirectness, imprecision

The mean cognitive function: extradimensional (eds) set shift errors at 30 minutes in the control groups was

4.44

The mean cognitive function: extradimensional (eds) set shift errors at 30 minutes in the intervention group was

2.66 lower

(7.12 lower to 1.8 higher)

Cognitive function: Spatial working memory: between-search errors

18

(1 study)

30 minutes

⊕⊝⊝⊝

VERY LOW1,2,3

due to risk of bias, indirectness, imprecision

The mean cognitive function: spatial working memory: between-search errors at 30 minutes in the control groups was

9.26

The mean cognitive function: spatial working memory: between-search errors at 30 minutes in the intervention group was

2.17 lower

(7.41 lower to 3.07 higher)

Cognitive function: Spatial working memory: strategy score

18

(1 study)

30 minutes

⊕⊝⊝⊝

VERY LOW1,2,3

due to risk of bias, indirectness, imprecision

The mean cognitive function: spatial working memory: strategy score at 30 minutes in the control groups was

31.78

The mean cognitive function: spatial working memory: strategy score at 30 minutes in the intervention group (clonidine) was

0.22 lower

(5.92 lower to 5.48 higher)

Cognitive function: pattern recognition - number correct

18

(1 study)

30 minutes

⊕⊝⊝⊝

VERY LOW1,2,3

due to risk of bias, indirectness, imprecision

The mean cognitive function: pattern recognition - number correct at 30 minutes in the control groups was

21.4

The mean cognitive function: pattern recognition - number correct at 30 minutes in the intervention group was

0.9 higher

(0.77 lower to 2.57 higher)

Cognitive function: spatial recognition - number correct

18

(1 study)

30 minutes

⊕⊝⊝⊝

VERY LOW1,2,3

due to risk of bias, indirectness, imprecision

The mean cognitive function: spatial recognition - number correct at 30 minutes in the control groups was

15.3

The mean cognitive function: spatial recognition - number correct at 30 minutes in the intervention group was

0.1 lower

(2.44 lower to 2.24 higher)

Cognitive function: spatial span - length

18

(1 study)

30 minutes

⊕⊝⊝⊝

VERY LOW1,2,3

due to risk of bias, indirectness, imprecision

The mean cognitive function: spatial span - length at 30 minutes in the control groups was

6.1

The mean cognitive function: spatial span - length at 30 minutes in the intervention group was

0.3 higher

(0.84 lower to 1.44 higher)

Cognitive function: delayed matching to sample 2 sec delay

18

(1 study)

30 minutes

⊕⊝⊝⊝

VERY LOW1,2,3

due to risk of bias, indirectness, imprecision

The mean cognitive function: delayed matching to sample 2 sec delay at 30 minutes in the control groups was

7.78

The mean cognitive function: delayed matching to sample 2 sec delay at 30 minutes in the intervention group was

1.22 lower

(2.65 lower to 0.21 higher)

Cognitive function: paired associate learning - sets completed

18

(1 study)

30 minutes

⊕⊝⊝⊝

VERY LOW1,2,3

due to risk of bias, indirectness, imprecision

The mean cognitive function: paired associate learning - sets completed at 30 minutes in the control groups was

8.89

The mean cognitive function: paired associate learning - sets completed at 30 minutes in the intervention group was

0 higher

(0.3 lower to 0.3 higher)

1

Downgraded by 1 increment if the majority of the evidence was at high risk of bias, and downgraded by 2 increments if the majority of the evidence was at very high risk of bias

2

The majority of the evidence included an indirect population (downgraded by one increment): downgraded if the ME/CFS diagnostic criteria used did not include PEM as a compulsory feature [original analysis]; percentage of participants with PEM unclear [PEM reanalysis – see Appendix G for additional details]

3

Downgraded by 1 increment if the confidence interval crossed one MID or by 2 increments if the confidence interval crossed both MIDs

Studies included: Morriss 2002

From: Pharmacological interventions

Cover of Pharmacological interventions
Pharmacological interventions: Myalgic encephalomyelitis (or encephalopathy) / chronic fatigue syndrome: diagnosis and management: Evidence review F.
NICE Guideline, No. 206.
National Guideline Centre (UK).
Copyright © NICE 2021.

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