Clinical recommendation	Evidence rating	References	Comments
Exercise therapy should be prescribed for patients with fatigue, regardless of etiology.	A	16–18, 32, 43, 44, 46	There is no evidence that exercise therapy worsens outcomes.
Selective serotonin reuptake inhibitors, such as fluoxetine (Prozac), paroxetine (Paxil), or sertraline (Zoloft), may be helpful for patients with fatigue in whom depression is suspected.	B	22, 49	A six-week trial is recommended to evaluate effectiveness.
Cognitive behavior therapy is an effective treatment for adult outpatients with chronic fatigue syndrome.	A	22, 47, 48	—
Stimulants seldom return patients to predisease performance.	B	21, 45	Stimulants are associated with headaches, restlessness, insomnia, and dry mouth.