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CFS Toolkit - Treatment and Management

Rationale for management

  • Treat other illnesses or conditions occurring at the same time as CFS or underlying medical/psychiatric conditions.
  • Identify the most bothersome symptoms.
  • Employ drug therapy to relieve symptoms.
  • Empower the patient to be active in managing the illness.

Drug therapies

  • Use as few medications as possible.
  • Remember that supplements and over-the-counter drugs can interact with prescription drugs and cause side-effects, please consult with a clinician before taking any of these medications.
  • Start with a small dose because many CFS patients are sensitive to medications.
  • Narcotics are not indicated for management of CFS-associated pain.
  • Medicine for pain or discomfort should be limited to acetaminophen, aspirin, or NSAIDS (nonsteroidal anti-inflammatory drugs).
  • Do not routinely use sleep medications to treat sleep problems. Sleep medication should be prescribed based on patient’s responses to a complete sleep history.
  • Treat clinical depression only. People with CFS may show signs of depression, but not have depression. Prescribing drugs for depression when a person is not depressed may make symptoms worse.
  • Use caution in prescribing/taking antidepressants. Some antidepressants may make individual CFS symptoms worse or cause side effects.
  • While use of a multivitamin is generally recommended for people who do not have balanced diets, it is not beneficial to buy trendy, expensive vitamins that have no effect on fatigue or pain.
  • Avoid unsafe herbal remedies like comfrey, ephedra, kava, germander, chaparral, bitter orange, licorice root, and yohimbe.

Non-drug therapies

  • Consider complementary therapies like acupuncture, gentle massage, deep breathing, relaxation therapy, yoga, or tai chi to increase energy and decrease pain.
  • Suggest stretching and light exercise before bed.
  • Help patients cope with memory difficulties by suggesting the use of organizers and schedulers. Puzzles, word games, and card games are other options to help increase focus.
 

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