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Medical treatments for chronic fatigue syndrome
As the cause of this syndrome is not known with certainty, there is no specific treatment for chronic fatigue syndrome whose effectiveness has been clearly demonstrated.
In practice, the treatments aim to relieve symptoms, to give the maximum ofautonomy to the patient and to maximize his capacity.
As the treatment is not specific, many approaches are interesting to aim at reducing as much as possible the exhaustion of the patients:
– Follow the rules of hygiene, health and diet;
– Very slow muscle rehabilitation (sometimes sessions of only 2 minutes 2-3 times a week at the start);
– Find and treat the source of infection (teeth, sinuses, etc.);
– Relaxation, sophrology, meditation, yoga;
– Behavioral therapy, psychological support;
– Sleep regulation;
– Eliminate allergy factors and treat allergies (frequent in this syndrome);
– Balance the intestinal flora;
– Treat respiratory disorders;
– Treat a state of post traumatic stress resulting from an old trauma.
Medical treatments for chronic fatigue syndrome: understand everything in 2 min
According to Canadian Consensus on Myalgic Encephalomyelitis / Fatigue Syndrome chronic1, treatments should ideally respect the rythme of the person as well as his limit1. Here is an overview of the recommendations included in this report.
Self-help approaches
The objective of a self-therapy strategy is to help the affected person conserve their energy, minimize their symptoms and improve their coping skills and their ability to carry out daily activities.
Getting to know the disease and the ways to fight it
Knowing about the disease and knowing what to expect is important in developing self-help strategies. The affected person must learn to recognize the warning signs and stop before you have exceeded your limits. It is beneficial to know the relaxation techniques and stress reduction, energy conservation (see Complementary approaches) andavoid aggravating factors known.
Develop your ability to adapt
- Rely on their impressions and experiences to determine their limit activity.
- Reserve from time to rest and indulge in an activity that pleases us.
- Repel gradually its limits, when we are able, without never exesto sell.
Improve your sleep
Use all techniques to improve sleep.
- Go to bed at regular times.
- Take a lukewarm bath.
- Do not use the bed for anything other than sleeping or having sex.
- Calm mental activity through meditation or relaxation techniques, etc.
- See our file Did you sleep well ?.
Have a balanced diet
- Ensure a balanced and nutritious diet (see How to eat well?).
- Eat at regular times.
- Drink enough.
- If needed, take food supplements and a multienzyme tablet in case of irritable bowel syndrome or digestive problems.
Another element can help considerably: meeting people suffering from the same syndrome (In France: French association of chronic fatigue syndrome http://www.asso-sfc.org/)
Two therapies that work: towards a new therapeutic approach? A study conducted in England, published in the prestigious journal Lancet and March 20114, was conducted over 52 weeks with 641 people with chronic fatigue syndrome. According to this study: — The combination of progressive physical activity and medical monitoring led to improved energy levels and physical abilities for 61% of subjects. — The combination of cognitive behavioral therapy and medical monitoring resulted in a decrease in symptoms with comparable effectiveness (for 59% of subjects). On the other hand, the group of patients who followed the strategy of self-treatment alone (as described in this sheet: adapting to the disease, reducing activities accordingly, etc.) saw their symptoms decrease by only 42%, a result roughly equivalent to that of a medical follow-up alone. The approach advocated in this study assumes that it is possible to recover of this syndrome, instead of having to constantly adapt to it by combining several approaches. (See our new Chronic Fatigue Syndrome: 2 Therapies That Work, for more details.) |
Physical activity
An initial assessment should precede the development of a activity program under the supervision of a person qualified in exercise physiology and with an in-depth knowledge of chronic fatigue syndrome. The objective of this program is to improve the ability to function well on a daily basis, while respecting the cardiovascular capacities highlighted during the evaluation. However, it is imperative to decide for yourself the intensity and pace of the exercises.
Un discomfort or a physical fatigue disproportionately after an effort is a feature distinctive and a criterion chronic fatigue syndrome. A physical exercise program must therefore be adapted to each patient to avoid causing relapses or worsening symptoms. It may be advisable to start with periods of activity as short as 2 minutes, 3 times per week. Physical exercise is as important to avoid muscle wasting associated with inactivity as it is to fight fatigue. |
pharmaceuticals
Many drugs have been proposed to treat chronic fatigue syndrome et none has proven to be highly effective to relieve this syndrome as a whole.
Disorders sleep
In addition to the treatment strategies described above, the doctor may prescribe, as appropriate, tricyclic antidepressants at low doses, zopiclone, clonazepam and L-tryptophan. These drugs sometimes also have an action on pain.
Selective serotonin reuptake inhibitors (eg Prozac®) can make sleep problems worse.
pain
Pain relievers. As a basic treatment: paracetamol or acetaminophen. For a short time, aspirin, ibuprofen, nonsteroidal anti-inflammatory drugs (NSAIDs), low dose tricyclic antidepressants, gabapentin or baclofen may be helpful.
Tiredness
Methylphenidate, cyanocobalamin (vitamin B12) by mouth, modafinil, amantadine, dextroamphetamine. Most of these drugs only have a short term effect. High-dose vitamin B12 injections have benefited some people even though they had a normal blood count1.
Cognitive problems
Methylphenidate, modafinil, nimodipine, dextroamphetamine, cyanocobalamin (vitamin B12) sometimes give some results.
Depression, anxiety
For depression, doctors may prescribe serotonin reuptake inhibitors (SSRIs), low-dose tricyclic antidepressants (which also reduce muscle pain), and anti-anxiety medications to treat symptoms associated with depression. Note that anxiety and depression are also taken care of by behavioral and cognitive therapies.