There is a wide range of common side effects of therapy. These side effects have to be considered in counseling patients who opt for treatment and in the planning of future randomized trials.
The main issue concerning the treatment of fatigue is addressing the complex, multifaceted etiology of fatigue. In order to obtain effective treatments, it is critical to understand the neurobiological mechanisms underlying the development of fatigue.
This article discusses the current treatments for fatigue including pharmacological and non-pharmacological interventions for reducing the symptom of this debilitating condition. Many interventions have been described, in the literature, such as cognitive behavioural therapy, relaxation, exercise, and medications like the benzodiazepines, antidepressants such as the selective serotonin reuptake inhibitors, and anticonvulsants. Of these, cognitive behavior therapies and selective serotonin reuptake inhibitors are frequently recommended. In the management of fatigue, the clinician should always consider patient preference and their capacity to participate in the therapeutic process.
There are many different ways to experience fatigue, but to summarize each aspect of the experience, you have to acknowledge the underlying process. The two general aspects of fatigue experience are the subjective experience in which the mood of the person is affected and the objective experience of reduced efficiency or loss of function which arises from physiological factors. The subjective way tiredness is perceived by an individual can take the form of the sensation of not getting enough sleep, a feeling as if one is just "not up to it" or a general tiredness that goes from one moment to the next. But the objective way tiredness is measured as a loss of energy, not so much a lack of capacity or function as some type of power deficit.
As the fatigue and fatigue severity score (FAS) provides a rating of a subject's subjective fatigue, the correlation between subjective and objective measure and fatigue can be assessed. Subjective fatigue is measured by self-administered scales (such as the FAS, or the fatigue symptom checklist or other measures). Objective measure by measures to assess physical tiredness or exhaustion level. A summary of these measures showing a clear correlation between subjective and objective scores should alert the physician to suspicion of persistent fatigue syndrome. The FAS scale is reliable, with high internal consistency for measurement properties across research studies.
[Between 1 in 6 and 1 in 11 Americans were surveyed in 2005-2006 and reported to have at least one day a year [through fatigue]] (https://www.cdc.gov/measur/fatigue2.html).
Fatigue is a complex disorder that can affect both physical and mental faculties, and the autonomic nervous system and hypothalamic-pituitary-adrenal axis also play an important role. A systematic approach, which aims to identify and understand specific symptom clusters and to find effective treatments, will be required for the management of fatigue.
Patient characteristics that are often identified in clinical research evaluations for fatigue as a primary or secondary end point are not related to baseline fatigue level, quality of life, or depression. Because these characteristics do not appear to influence fatigue levels, fatigue appears to be a less useful endpoint versus fatigue-specific QOL or function measurements in clinical trials. Future studies should address the impact of fatigue on quality of life.
Both patient and carer satisfaction were high. Overall, there are significant improvements in the management of pain, with a reduced number of side effects, and a decreased number of hospitalisations.
As of 2015, multiple factors contribute to fatigue: psychological, physical, and cognitive. Physical fatigue has physical and psychological components. Psychosocial fatigue is a condition of the subjective experience of fatigue, and can be treated through a variety of physical, psychological, and educational therapies. There is some preliminary evidence for fatigue management and treatment with serotonin modulating compounds to improve fatigue. However, because these approaches are still in the early stages of testing, the full potential of these therapies for treating fatigue is not yet clear.
A wide breadth of treatment modalities is used in combination. Some treatments were commonly combined in all treatments, while others were often used by only a small portion of patients. For example, behavioral techniques were used in most CBT and motivational group programs, but rarely in individualized treatments.