Many patients do not fully recover from CFS, even with treatment.[1] Some management strategies are suggested to reduce the consequences of having CFS. Medications, other medical treatments, complementary and alternative medicine are considered. A systematic review has shown that CFS patients are less susceptible to placebo effects than predicted, and have a low placebo response compared to patients with other diseases.[2] CFS is associated with chemical sensitivity,[3][4] and some patients often respond to a fraction of a therapeutic dose that is normal for other conditions.[5][6]
A 2005 review in the journal Curr Med Chem. concluded, “it seems that major drug targets in stress-related disorders are immune cells in terms of inhibition of proinflammatory cytokines and modulation of Th (cytokine pattern) responses”. In CFS, in a series of recent therapeutic trials several immunomodulating agents have been used, such as staphypan Berna, lactic acid bacteria, kuibitang and intravenous immunoglobulin. In particular, according to recent evidences, antidepressants seem to exert beneficial effects in augmenting NK cell activity in depressed patients. [7]
Improvement may occur with medical care and additional therapies of pacing, cognitive behavioral therapy (CBT) and graded exercise therapy (GET). The latter two therapies have been found to be efficacious in small trials, but patient organisations surveys have reported adverse effects.[8] Interventions involving rehabilitation therapies have been shown to be at least partially effective in some people with CFS. [9][10][11][12]
Some therapies recommended by different sources include:
↑Rimes KA, Chalder T. (2005). "Treatments for chronic fatigue syndrome". Occupational Medicine. 55 (1): 32–39. doi:10.1093/occmed/kqi015. PMID15699088.
↑Cho HJ, Hotopf M, Wessely S (2005). "The placebo response in the treatment of chronic fatigue syndrome: a systematic review and meta-analysis". Psychosom Med. 67 (2): 301–13. doi:10.1097/01.psy.0000156969.76986.e0. PMID15784798.CS1 maint: Multiple names: authors list (link)
↑Jason LA, Taylor RR, Kennedy CL (2000). "Chronic fatigue syndrome, fibromyalgia, and multiple chemical sensitivities in a community-based sample of persons with chronic fatigue syndrome-like symptoms". Psychosom Med. 62 (5): 655–63. PMID11020095.CS1 maint: Multiple names: authors list (link)
↑Clauw DJ (2001). "Potential mechanisms in chemical intolerance and related conditions". Ann. N. Y. Acad. Sci. 933: 235–53. PMID12000024.
↑Gruber AJ, Hudson JI, Pope HG (1996). "The management of treatment-resistant depression in disorders on the interface of psychiatry and medicine. Fibromyalgia, chronic fatigue syndrome, migraine, irritable bowel syndrome, atypical facial pain, and premenstrual dysphoric disorder". Psychiatr. Clin. North Am. 19 (2): 351–69. doi:10.1016/S0193-953X(05)70292-6. PMID8827194.CS1 maint: Multiple names: authors list (link)
↑[Chambers D, Bagnall AM, Hempel S, Forbes C (2006). "Interventions for the treatment, management and rehabilitation of patients with chronic fatigue syndrome/myalgic encephalomyelitis: an updated systematic review". Journal of the Royal Society of Medicine. 99 (10): 506–20. doi:10.1258/jrsm.99.10.506. PMID17021301.CS1 maint: Multiple names: authors list (link)
↑Jason LA, Melrose H, Lerman A; et al. (1999). "Managing chronic fatigue syndrome: overview and case study". AAOHN J. 47 (1): 17–21. PMID10205371.CS1 maint: Explicit use of et al. (link) CS1 maint: Multiple names: authors list (link)