Intended for healthcare professionals


NICE backtracks on graded exercise therapy and CBT in draft revision to CFS guidance

BMJ 2020; 371 doi: (Published 10 November 2020) Cite this as: BMJ 2020;371:m4356
  1. Ingrid Torjesen
  1. London, UK

Graded exercise therapy (GET) should no longer be offered for the treatment of chronic fatigue syndrome (CFS, also known as myalgic encephalomyelitis), the National Institute for Care and Health Excellence (NICE) says in draft guidance.1 Instead patients should be encouraged to remain within their “energy envelope” so as not to worsen their symptoms, it advises.

Likewise, cognitive behavioural therapy (CBT) should no longer be offered as a treatment, NICE adds, although it can be offered as a psychological therapy that aims to help patients to manage their symptoms.

The revisions have been based not only on published evidence but also on patient reports that the treatments did not benefit them, and that in some cases GET caused harm.

In July, NICE cautioned against the use of GET for patients recovering from …

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