Treatment of the underlying cause |
Anemia - Red blood cell transfusion or an erythropoiesis-stimulating agent, most useful in patients receiving chemotherapy who have severe anemia |
Deconditioning - Exercise |
Dehydration - Intravenous or subcutaneous fluids |
Depression - Antidepressants |
Hypogonadism - Testosterone replacement therapy |
Hypothyroidism - Check TSH |
Hypoxia - Oxygen, if hypoxemic (eg, oxygen saturation <90% by pulse oximetry) |
Infections - Antibiotics |
Insomnia - Sleep hygiene, brief trial of short-acting hypnotics in refractory cases |
Metabolic and endocrine disorders - Correction of disorder (eg, thyroid or testosterone replacement) |
Pain - NSAIDs, opioids |
Treatment of the symptom |
Established therapies - Glucocorticoids, megestrol acetate |
Less well-established therapies - Methylphenidate, modafinil, American ginseng |
Alternative therapies - Melatonin, fish oil, yoga, and meditation |