special subjects
Chronic Fatigue Syndrome
Treatment of Chronic Fatigue Syndrome
Acknowledgment of patient's symptoms Sometimes cognitive-behavioral therapy Sometimes graded exercise, limited to avoid a setback Medications for depression, sleep, or pain if indicated To provide effective care to patients with CFS, physicians must acknowledge and accept the validity of patients' symptoms. Whatever the underlying cause, these patients are not malingerers but are suffering and strongly desire a return to their previous state of health. For successful management patients need to accept and accommodate their disability, focusing on what they can still do instead of lamenting what they cannot do. Cognitive-behavioral therapy and a graded exercise program have been helpful in some studies but not in others ( Treatment references , If these measures are ineffective, hypnotic medications and/or referral to a sleep specialist may be necessary. Patients with pain (usually due to a component of Fibromyalgia ) can be treated using a number of medications such as Unproven or disproven treatments, such as antivirals, immunosuppressants, elimination diets, and amalgam extractions, should be avoided. 1.Vink M, Vink-Niese A: Graded exercise therapy for myalgic encephalomyelitis/chronic fatigue syndrome is not effective and unsafe. Re-analysis of a Cochrane review.Health Psychol Open5(2):2055102918805187, 2018. doi:10.1177/2055102918805187 2.Larun L, Brurberg KG, et al: Exercise therapy for chronic fatigue syndrome.Cochrane Database of Systematic ReviewsIssue 10. Art. No.: CD003200, 2019. doi: 10.1002/14651858.CD003200.pub8 