Treating Chronic Fatigue Syndrome is a serious challenge for a physician. For the patient, it is important to be aware that there are different approaches to treating it, and there can be a lot of adjustments in the treatment regimes. He needs to be appreciating that successful treatment needs coordinated efforts wherein his patience and cooperation is also vital.
Chronic Fatigue Syndrome or CFS is a condition of severe debilitating fatigue that results from uncertain causes and leads to severe deterioration in the quality of life apart from becoming an impediment in vocation and livelihood.
There are certain options available for treating this condition, but before going in to their details, one needs to understand certain aspects of treatment modalities of CFS.
- There is no single cure for treating chronic fatigue syndrome. In other words there is no particular treatment option that could be considered a treatment of choice in all cases of CFS.
- What works for one person diagnosed with CFS may not work with another labelled with the same condition. Thus for every person diagnosed with chronic fatigue syndrome, the patient and the doctor need to find the most effective treatment.
- Most of the time the treatment consists of more than one modality. For example, it may consist of medications, diet, exercise and certain precautions. It could be a mixture of prescription drugs and some forms of complimentary or alternative therapies. This may require a team of experts like physician, physiotherapist, dietician and others to work together for helping the person affected with this condition.
- Early initiation of treatment improves the chances of remission. Hence early diagnosis and identification of best treatment is a crucial step in managing chronic fatigue syndrome.
The main options of treatment consist of medical treatment, counselling and psychotherapy, exercise under close supervision and alternative or complimentary treatments.
1. MEDICAL TREATMENT
The following treatments have been advocated as having possible benefits. None of them is likely to benefit all cases, but they are worth trying depending upon the profile and likely causes.
- Antidepressants in low doses improve the quality of sleep and stress and thereby help in some relief from fatigue.
- Autonomic nervous system stimulants like atomoxetine, amphetamines and methylphenidate (Ritalin) provide some relief and benefit to the symptoms.
- Nicotinamide adenine dinucleotide or NADH has also been observed to bring some benefit to some persons suffering from CFS.
- Steroids and thyroid hormones have been shown to have some benefit in some cases.
- Immuno-modulation with medicines like intravenous immuno-gammaglobulin (IVIgG) have also been advocated, but results are still not consistently promising.
2. COUNSELLING & PSYCHOTHERAPY
Chronic fatigue syndrome is usually associated with severe psychological stress, frustration, anxiety and depression, which manifests in the form of sleep disorders, headache and even further fatigue. Thus countering it with professional counselling and cognitive behavioural therapy helps in enabling the person to relax and
3. ALTERNATIVE & COMPLIMENTARY MEDICINES
A large number of alternative and complimentary medicines and therapies have been attempted and have been associated with significant but inconsistent benefits. These include use of essential fatty acids, Magnesium and Cartinine as supplementary medicines. Other forms of treatments like massages, meditation techniques, yoga postures and deep breathing exercises have also been tried and found to provide some benefits.
4. CONTROLLED EXERCISES
One basic principle of exercise in chronic fatigue syndrome is the avoidance of all extremes. Strenuous exercise makes the condition worse and should be avoided. Absolute rest also worsens the condition, apart from leading to disuse atrophy of muscles. The most preferable option is to have mild gradually increasing exercises under the guidance of a physiotherapist, and without putting too much strain.
All these options need to be considered while choosing the treatment for CFS in a person. As the disease itself, the treatment is as complex. The best way would be to attempt different options with adequate coordination between different experts.
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