These drugs include ondansetron (small benefit in a small randomized trial), S-adenosyl-methionine (SAMe, small benefit in uncontrolled studies), pentoxifylline (no benefit), modafinil (no benefit), hydroxyzine, zolpidem, trazodone, and melatonin (no benefit for sleep quality and insomnia) ( In conclusion, non-pharmacological therapies that focus on controlling the etiology of liver disease, improving nutrition, increasing muscle mass, mitigating triggers and risk factors, and enhancing coping mechanisms are significantly more effective in combating fatigue in cirrhosis compared to pharmacological treatments (Figure 2) ( Figure 2 3 Cirrhosis-related appetite disorders, restrictive diet, and malnutrition 3.1 Prevalence, risk factors and mechanisms Chronic liver failure in end-stage cirrhosis often leads to low appetite, nutritional deficits, and malnutrition
Vitamin B12 is essential for various bodily functions, including red blood cell production, DNA synthesis, and maintaining a healthy nervous system
doi: 10.1186/s12940023-009721 58 YanagiYAssunoJVBarrozoLV
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