Regular exercise will improve functional capacity, mood, and sleep. Regular sleep habits should be advised. In those complaining of depressive symptoms or sleep disturbance, an antidepressant or sleep hypnotic is indicated. A sedating antidepressant, such as <<>>amitriptyline (Elavil) 25 mg qhs, may be helpful for complaints of insomnia or restlessness. If the primary complaints are hypersomnia and psychomotor retardation, a selective serotonin reuptake inhibitor is indicated.
For physical symptoms such as headaches, myalgias, or arthralgias, nonsteroidal anti-inflammatory agents may be helpful. Therapies for which no effectiveness has been demonstrated in CFS include vitamins, acyclovir, gamma globulin, folic acid, cyanocobalamin, and magnesium.
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