Chronic fatigue syndrome management

Treatment of chronic fatigue syndrome (CFS) is variable and uncertain, and the condition is primarily managed rather than cured. Only two treatments, cognitive behavioral therapy and graded exercise therapy, have demonstrated reproducible evidence for their efficacy people with CFS who are walking. There are no Food and Drug Administration (FDA) approved medications for ME/CFS treatment, although medications are used without approval for the illness (off-label). Drugs have been used in experimental studies of the illness that haven't been approved for market for any condition in the United States (for example, isoprinosine and rintatolimod). Other proposed treatments include medical treatments and alternative medicine. Even when treated, the prognosis of CFS is often poor. In one study, poor early management was reported to be a main risk factor for severe CFS (delayed diagnosis, poor response to analgesics, physiotherapy, or alternative medicine), with associated variables including a poor relationship with the GP before and after diagnosis, and the involvement of a psychiatrist in initial treatment.

CFS management techniques include behavioral interventions such as cognitive behavioral therapy (CBT, a form of psychological therapy), and graded exercise therapy (GET). Based on evidence from multiple randomized clinical trials (RCTs), a systematic review published in the Journal of the Royal Society of Medicine (October 2006) stated that CBT and GET interventions showed promising results, appearing to reduce symptoms and improve function. The review stated that the evidence of effectiveness was inconclusive for most other interventions, with some reporting significant adverse effects. The wide variety of outcome measures used in CFS research was found to be a "fundamental problem" for assessing the effectiveness of interventions in general, and no intervention has proven to be effective in restoring the ability to work.

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