Tiredness

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)

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