From the Guidelines
Cognitive-behavioral therapy (CBT) is the most recommended treatment for chronic fatigue, as it has been shown to significantly improve health function, health-related quality of life, and physical function in patients with chronic multisymptom illness (CMI) and symptoms consistent with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) 1. When treating chronic fatigue, it's essential to consider a multifaceted approach that includes lifestyle modifications, psychological interventions, and symptom management.
- Lifestyle modifications may include establishing consistent sleep habits, such as going to bed and waking at the same times daily, and a gradual exercise program like graded exercise therapy (GET).
- Psychological interventions, particularly CBT, have been found to be effective in managing the psychological aspects of chronic fatigue, with studies showing significant improvements in health-related quality of life and physical function 1.
- Symptom management may involve over-the-counter pain relievers, such as acetaminophen or ibuprofen, and low-dose antidepressants like amitriptyline to improve sleep and reduce pain. It's crucial to note that stimulants are not recommended for the treatment of fatigue in patients with CMI and symptoms consistent with ME/CFS 1. Additionally, while mindfulness-based therapies have shown promise in improving quality of life outcomes for patients with FMS and IBS, CBT remains the most strongly supported treatment for chronic fatigue 1. Proper nutrition, pacing activities, and avoiding energy crashes are also essential for managing energy levels and reducing symptoms. Overall, a comprehensive treatment plan that incorporates CBT, lifestyle modifications, and symptom management can help improve health outcomes and quality of life for patients with chronic fatigue.
From the Research
Treatment Options for Chronic Fatigue
- Exercise therapy has been shown to be effective in reducing fatigue in patients with chronic fatigue syndrome (CFS) 2
- Cognitive behavioral therapy (CBT) has also been found to improve physical function and fatigue in patients with mild to moderate CFS 3
- Multidisciplinary rehabilitation treatment, which includes cognitive behavioral therapy, has been shown to be more effective than CBT alone in reducing long-term fatigue severity in patients with CFS 4
Components of Effective Treatment
- Exercise therapy may include aerobic exercise such as walking, swimming, or cycling, and can be tailored to the individual's needs and abilities 2
- CBT may include components such as sleep management, activity management, and cognitive intervention to address patients' beliefs about their illness 3, 5
- Multidisciplinary rehabilitation treatment may include a combination of medical, psychological, and behavioral interventions, as well as involvement of family members and employers 5, 4
Outcomes and Effectiveness
- Studies have shown that exercise therapy and CBT can lead to significant improvements in fatigue, physical function, and quality of life for patients with CFS 2, 3, 4
- Multidisciplinary rehabilitation treatment has been shown to be effective in reducing long-term fatigue severity and improving quality of life for patients with CFS 4
- The effectiveness of treatment may depend on the individual's specific needs and circumstances, and may require ongoing support and monitoring 5, 6