Treating symptoms
Once a doctor has sifted through possible causes for fatigue, he then takes cues from the body, treating each symptom individually instead of searching for a blanket fatigue treatment. “If there’s inflammation, I treat that. If depression, I try to make that better. If a certain activity or task is draining, occupational or physical therapy may help. And if sleep or medications are to blame, I’ll make adjustments,” says Dr. Pischel.
Your doctor can help relieve your most troublesome symptoms – prescribing nsaids, dmards, biologic agents or corticosteroids to reduce inflammation or prescribing iron treatments or the hormone epoietin (Epogen, Procrit) to reduce anemia. But there are several other tactics that will help you beat fatigue and prevent it from returning.
What your doctor can do:
Stimulant medications. “People who say their unrelenting fatigue is more of a problem than their pain may need ‘activating’ medications that increase energy,” says Daniel Clauw, MD, rheumatologist and director of the Chronic Fatigue and Pain Research Center at the University of Michigan.
Some antidepressants, such as buproprion (Wellbutrin), are used as activating medications, as is the psychostimulant medication modafinil (Provigil), which reduces the excessive sleepiness brought on by sleep disorders such as narcolepsy or sleep apnea. “The combination of drugs such as activating agents and non-drug therapies such as exercise and cognitive behavior therapy reduces fatigue and increases energy in many cases,” he says.
Sleep medications. For people who have trouble falling asleep or staying asleep at night due to anxiety or insomnia, a host of newer sleeping pills promote restorative sleep while reducing or preventing next-day grogginess. These newer medications, including eszopiclone (Lunesta), lorazepam (Ativan), zaleplon (Sonata) and zolpidem (Ambien) may be less likely to trigger low-dose dependence than older sleep medications or mild tranquilizers, including alprazolam (Xanax), clonazepam (Klonopin) and diazepam (Valium).
While these newer medications are not free of side effects – headaches and daytime sleepiness still occurred in some of the people studied – you may find relief by working with your doctor to find the right dose or fatigue treatment combination.
