No specific drug for the treatment of fatigue in palliative care

Cochrane: In an advanced disease such as cancer, fatigue can be described as tiredness, weakness or lack of energy. Fatigue can affect daily activity and quality of life, and it is frequently reported by palliative care patients. The underlying causes of fatigue are not very well understood and fatigue is difficult to treat. We searched the literature in April 2014 and found 45 randomised controlled trials for this update of the review.

Chronic fatigue syndrome

Chronic fatigue syndrome is  characterized by intense fatigue of unknown cause, which is permanent and limits the patient's functional capacity, producing various degrees of disability.
It combines, since at least six months :

• a sensation of intense tiredness, of infectious kind, with at least 50 % reduction of daily activity;
• memory, concentration, and mood disorders, which can remind of a depressive or generalized anxiety chart
• functional disorders  (locomotor, digestive, cardio-respiratory...) like "somatization" symptoms (hypocondria, hysteria...).
• Sleep disorders: insomnia, hypersleepiness 

More about chronic fatigue syndrome

Chronic fatigue syndrome

Source: Alfredo Avellaneda Fernández, Álvaro Pérez Martín and coll. BMC Psychiatry.

What is chronic fatigue syndrome?

The chronic fatigue syndrome (CFS) is fundamentally characterized by intense fatigue of unknown cause, which is permanent and limits the patient's functional capacity, producing various degrees of disability.

Burnout and Karoshi

Author: Dr Peremarty MD: Sleep and general medicine

A syndrome at the turning point between tiredness and depression?

Burnout is a human relationship disease, close to depressive state, preceded by a heavy load of stress combined with a lot of personal frustration.
Its evolution, which remains silent over a long period, can end in suicide (in case of depression) or induce health endangering behaviours (tobacco, alcohol, drugs and medication abuse).
In Japan, Karoshi, (or Karushi - literally: death (shi) from overwork (karu) - describes a decease (no matter the cause of death itself) related to an excessive work schedule .

Hypersomnia

Author: Dr Peremarty MD: Sleep and general medicine

In October, the marmot enters a period of hibernation, which lasts about six months. Here, the need for sleep is more important than in average sleepers (more than 10 hours).

No matter how intense his/her « stress level » can be, that subject will never know the dread of insomnia.
He/she is under a constant excessive sleep pressure and takes advantage of every opportunity to « doze off a little ». (And is teased by friends how consider him/her like a « marmot »).
If possible, the person will adopt fitted out work schedules which leave opportunities to satisfy his/her need for sleep.
The diagnosis requires that pseudo-hypersomnias and secondary hypersomnias are taken into account.

Sleep insufficiency because of an excessive need ...

Chronic Fatigue Syndrome

Author: Dr Peremarty MD. Chronic fatigue syndrome.

An invisible sleep pathology, "wake up more tired than the day before"

An illness on the border between psychology and physiology...

Definition:
CFS is a clinical chart which combines, since at least six months :

• a sensation of intense tiredness, of infectious kind, (with, sometimes, a feeling of a little fever or swollen ganglions), carrying with it a significant reduction (at least 50 %) of daily activity;
• memory, concentration, and mood disorders, which can remind of a depressive or generalized anxiety chart;