The chronic fatigue syndrome: clinical-pathophysiological, diagnostic and differential-diagnostic aspects (the literature review and data of own observations). Part 2

Abstract

The chronic fatigue syndrome (CFS) is a pathological condition, the incidence of which is constantly increasing worldwide, but reliable therapeutic and prophylactic rehab programs have not been developed yet. The paper elucidates the literature data from domestic and foreign sources concerning current methods of prevention, treatment and rehabilitation of CFS patients, as well as attempts to outline possible perspectives in this direction. It is stated that the treatment and rehabilitation of CFS patients should be based on the use of nonmedicated complexes (minimizing risk factors, controlled physical activity, cognitive behavioral therapy, wellness nutrition), and medications (analgesics, anti­depressants, activators of metabolism, immuno­regulators and alternative medicine). The general treatment principles of patients with CFS according to the international practice have been presented. The main stage of treatment lasts for 12 weeks with the use of multicomponent pharmacologic agents of multidirectional metabolitotropic, immune-corrective action as the basic factors against the background of the abovementioned non­drug and drug approaches. Further stages of rehabilitation are planned in a personalized way, with account of risk factors, social support measures, training and motivation of patients to actively participate in the treatment process. Further stages of rehabilitation can take months and years. The complete recovery is observed not very often, but the long­term remissions are frequent, and CFS recurrence depends on the properly designed treatment programs and the degree of their implementation by the patients. The ways to improve the above methods for over the past 10 years have been shown, and possible prospects in the aspect of rehabilitation of such patients have been outlined. The anticipated changes can be predicted for the treatment paradigm of this disorder from symptomatic therapy to the pathogenetic approach. The syndrome of chronic fatigue is a complex pathological state that is difficult to be treated, and the existing treatment and prophylactic methods require further improvement.