Tiredness is closely related to cachexia/anorexia and may be due to advanced disease. Start by determining if the tiredness could be due to reversible causes.
Reversible causes
Start by determining if the cause is reversible:
- pain or dyspnea
- insomnia
- anemia
- hypothyroidism
- medication side-effects
- distress: depression/anxiety
Drugs
For insomnia:
Methotrimeprazine
- 2.5-10mg po/sc HS
Zopiclone
- 3.75-15mg po HS
Trazadone
- 12.5-50mg po HS
Other therapies
- encourage exercise, if possible
- pace level of activity: prioritize activities so energy is available for most meaningful ones, and limit visitors
- transfuse if anemic (but do not repeat if there’s no benefit)