Treatment
The most effective current treatment for some medically unexplained symptoms is a combination of therapeutic approaches tailored to the individual patient. Most MUS patients are in need of psychotherapy, relaxation therapy and physiotherapy under medical supervision. A Combined therapeutic approach which is at least twice as effective as other therapeutic modalities published to date is described in Steele RE et al. "A novel and effective treatment modality for medically unexplained symptoms" The next best documented approach is cognitive behavioral therapy (CBT), with evidence from multiple randomized controlled trials. Antidepressants may also help, but the evidence is "not yet conclusive." The effectiveness of CBT and antidepressants has not been studied for all medically unexplained symptoms, however. Evidence for a positive effect of CBT has been found in trials for fibromyalgia, chronic fatigue syndrome, irritable bowel syndrome, unexplained headaches, unexplained back pain, tinnitus, and non-cardiac chest pain. As of 2006, CBT had not been tested for menopausal syndrome, chronic facial pain, interstitial cystitis, or chronic pelvic pain.
For antidepressants, both tricyclic antidepressants (TCAs) and selective serotonin reuptake inhibitors (SSRIs) have been tested for some medically unexplained symptoms. TCAs have effects on IBS, fibromyalgia, back pain, headaches, and possibly tinnitus, and single studies show a possible effect in chronic facial pain, non-cardiac chest pain, and interstitial cystitis. SSRIs are usually not effective or have only a weak effect. One exception is menopausal syndrome, where SSRIs are "possibly effective" as well as a third class of antidepressants, the serotonin-norepinephrine reuptake inhibitors (SNRIs).
A randomized controlled trial of multi-faceted, collaborative care found some improvement in the mental health of people with forms of MUS involving somatoform disorders and psychological distress.
Read more about this topic: Medically Unexplained Physical Symptoms
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