Painful cervical or axillary lymph nodes 4. Generalized muscle weakness 5. Fatigue postexercise 7. 10.Sleep disturbance 11.History that fatigue and associated symptoms developed abruptly Physical Findings 1. No specific therapies exist for chronic fatigue syndrome.
Treatment is symptomatic, supportive, and psychosocial.
Sleep disturbances often respond to treatment with benzodiazepines or Zolpidem for initiation of sleep and reduction of prolonged sleep latency. Tricyclic antidepressants, especially amitriptyline, taken at low doses 2 hours or less before bedtime, are useful for reduction in early awakening. Amitriptyline at low doses may prove helpful in initiating sleep and may improve myalgias as well. Long-acting nonsteroidal antiinflammatory agents may be more effective in treating myalgias and arthralgias, especially with use of a prebedtime dose for nocturnal muscle discomfort, which Patients with obvious psychologic dysfunction, either primary or secondary, should be referred to a psychiatrist or psychologist for evaluation and therapy. Attitudes, providing education to promote supportive assistance from family members and Alternative and complimentary interventions may be helpful, including stress reduction therapies, light massage, and meditation.