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.
- 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.
- 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.