Mirtazipine (Remeron) has helped my father-in-law regain weight and sleep at night through his post-nephrectomy adjuvant immunotherapy.

I've got a Ritalin prescription for when chemo fog keeps me from concentrating at work.

Between the Ritalin and caffeine, I can get through the mental fatigue most work days, but they only partially address the real physical fatigue.

I found that a blood transfusion (1 unit) was a huge energy booster for a few weeks after it was administered. My hemoglobin was not at the "acute low" threshold of 8.0, but had been chronically low (8.5-9.5) for so long it was impacting my ability to exercise.

A lot of doctors (including palliative docs and oncologists) still think in terms of the acute low hemoglobin treatment, but others are starting to consider blood transfusions based more on symptoms than just hemoglobin level. It's definitely an issue for those on long-term chemo/immunotherapy.

If the mirtazipine has a positive impact on her sleep quality, that might help with the fatigue as well.

Depression is also a big contributor to fatigue, so the mirtazipine might help on that front too, but it wouldn't hurt to explore other mental health avenues (counseling) if depression is involved.