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Chronic Fatigue Treatment Overview

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Care Plan


First steps to consider

  • If you have symptoms of chronic fatigue syndrome—fatigue, not feeling refreshed after sleep, a decline in your ability to function, and feeling exhausted after cognitive, emotional, or physical activity—see a healthcare provider.
  • Chronic fatigue syndrome is treated with a combination of medication, therapy, and lifestyle changes.
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Symptom relief

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  • Mild to moderate pain can be treated with OTC pain relievers.
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All treatments for chronic fatigue
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Read more about chronic fatigue care options

When to see a healthcare provider

Chronic fatigue syndrome (CFS), also called myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), should be treated by a healthcare provider. CFS usually requires long-term treatment that includes medication and therapy. Many people with CFS get some improvement in symptoms, though most do not fully recover.

Getting diagnosed

There is no test that confirms a diagnosis of CFS. Your healthcare provider will likely make the diagnosis after ruling out other conditions that can cause fatigue. Tests may include:

  • A blood test to check for conditions like hypothyroidism and anemia
  • A sleep study to make sure you don’t have a sleep disorder like narcolepsy or obstructive sleep apnea
  • Mental health screening to see if depression or anxiety is causing your fatigue

What to expect from your doctor visit

  • If you have depression, you may be treated with an antidepressant like sertraline (Zoloft) or with psychotherapy (talk therapy).
  • If you have chronic pain caused by CFS, your provider may recommend a prescription medication like amitriptyline (Elavil) or gabapentin (Neurontin).
  • Your provider may discuss cognitive behavioral therapy (CBT) with you. CBT can help you understand how your thoughts about activities lead to behaviors that ultimately make you feel more tired. But the research is mixed, showing that CBT may help some people but make symptoms worse in others.
  • You may be prescribed low-dose sleep medication if you have trouble getting restful sleep. Examples include amitriptyline (Elavil), zolpidem (Ambien), and clonazepam (Klonopin).
  • It’s important to try to remain active at a level that improves your health but does not trigger post-exertional malaise (feeling worse after you exercise).
  • Avoid treatments that are not supported by evidence, including antivirals, immunosuppressants, stimulants, elimination diets, and amalgam extractions. These may have side effects and minimal benefits.

Prescription medications for chronic fatigue syndrome

  • Prescription pain relievers: amitriptyline (Elavil), gabapentin (Neurontin), pregabalin (Lyrica), cyclobenzaprine (Flexeril)
  • Antidepressants: duloxetine (Cymbalta), venlafaxine, (Effexor), paroxetine (Paxil), fluoxetine (Prozac), sertraline (Zoloft)
  • Sleep medication: zolpidem (Ambien), clonazepam (Klonopin), eszopiclone (Lunesta), ramelteon (Rozerem), zaleplon (Sunesta), amitriptyline (Elavil)

Types of chronic fatigue syndrome providers

  • Your primary care provider can refer you to a specialist.
  • A psychiatrist is a medical doctor who specializes in psychiatric conditions. They can prescribe medication if you have CFS and depression or anxiety.
  • A sleep medicine physician can rule out sleep disorders and may treat CFS.
  • You may be referred to a rheumatologist, who specializes in treating inflammatory conditions. Some rheumatologists treat CFS.
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