No specific therapies for chronic fatigue syndrome (CFS) exist. The most your health care professional can do is treat your symptoms. If your health care professional has diagnosed you with chronic fatigue syndrome, he or she will probably help you manage the disease with the following:
- symptom-based treatment
- education about the disease
- regular follow-up visits to rule out alternative diagnoses
Sleep disturbances, pain, gastrointestinal difficulties, allergies and depression may be relieved with prescription and over-the-counter medications.
Lifestyle changes. While lifestyle changes cannot cure the symptoms of chronic fatigue syndrome, they can make life with CFS more manageable and enjoyable. Increased rest, the use of stress reduction and management techniques, dietary restrictions, nutritional supplementation and minimal exercise may be recommended by your health care professional. Supportive therapy, such as counseling, can also help you to identify and develop effective coping strategies.
You may also benefit from keeping an energy diary. Keep a log for several weeks, noting the times when you feel the most fatigued and what activities you performed during the day. This helps some people learn the patterns of their illness and identify factors that may be contributing to fatigue or other symptoms, such as headaches. Schedule naps and adjust your schedule to fit your energy patterns. Perhaps making time to relax and meditate during certain times of the day will be useful. Avoid situations that you know to be physically or psychologically stressful.
Work with your health care professional on a moderate exercise plan. Some CFS sufferers will experience profound fatigue even after very modest exercise, so start off slowly. Begin with as little as five minutes of moderate exercise, increasing the level of activity slightly every two or three weeks.
You may also learn to avoid certain triggers that aggravate CFS symptoms, such as a chemical, pesticide, household cleaning product, or another potential environmental toxin. In order to determine your triggers, remove all suspected toxins from your environment, then reintroduce them one by one to pinpoint what may be causing your symptoms.
Relief of aches and pains. Talk to your health care professional about how you can temporarily relieve the flu-like symptoms of chronic fatigue syndrome with over-the-counter medicines and prescription treatments. He or she may recommend a short course of nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin, ibuprofen (Advil, Motrin, Bayer Select, Nuprin), naproxen (Aleve, Anaprox, Naprosen), piroxicam (Feldene), and acetaminophen (Tylenol) for muscle aches, joint pain and headaches. Deep massage, stretching, and chiropractic treatment may also help minimize symptoms.
Medications to improve sleep and energy levels. Low doses of tricyclic agents are sometimes prescribed for CFS patients to improve sleep and to relieve mild, generalized pain. Examples include doxepin (Adapin, Sinequan), amitriptyline (Elavil, Etrafon, Limbitrol, Triavil), desipramine (Norpramin), and nortriptyline (Pamelor).
Medications to treat depression. Antidepressants have been used to treat depression in CFS patients, although non-depressed CFS patients receiving treatment with serotonin reuptake inhibitors (SSRIs) have been found by some physicians to benefit from this treatment as well or better than depressed patients. Examples of antidepressants used to treat CFS include SSRIs such as fluoxetine (Prozac), sertraline (Zoloft), and paroxetine (Paxil). Other types of antidepressants may also be used; these include venlafaxine (Effexor), trazodone (Desyrel), and bupropion (Wellbutrin).
Patients with chronic fatigue syndrome often respond to lower doses of antidepressant medications than doses typically used to treat depression. In fact, many CFS patients cannot tolerate the typical doses prescribed for depression. It often takes several weeks for these drugs to produce benefits, so be patient and work with your health care professional to find the drug that is best for you.
Copyright 2003 National Women's Health Resource Center Inc. (NWHRC)