Contrasting neuroendocrine responses in depression and chronic fatigue syndrome

doi:10.1016/0165-0327(95)00026-J

Journal of Affective Disorders

Volume 34, Issue 4, 18 August 1995, Pages 283-289

https://doi.org/10.1016/0165-0327(95)00026-J Get rights and content

Abstract

Hypothalamic-pituitary-adrenal (HPA) axis and central 5-HT function were compared in chronic fatigue syndrome (CFS), depression and healthy states. 10 patients with CFS and 15 patients with major depression were matched for age, weight, sex and menstrual cycle with 25 healthy controls. Baseline-circulating cortisol levels were highest in the depressed, lowest in the CFS and intermediate between the two in the control group (P = 0.01). Prolactin responses to the selective 5-HT-releasing agent d-fenfluramine were lowest in the depressed, highest in the CFS and intermediate between both in the healthy group (P = 0.01). Matched pair analysis confirmed higher prolactin responses in CFS patients than controls (P = 0.05) and lower responses in depressed patients than controls (P = 0.003). There were strong inverse correlations between prolactin and cortisol responses and baseline cortisol values. These data confirm that depression is associated with hypercotisolaemia and reduced central 5-HT neurotransmission and suggest that CFS may be associated with hypocortisolaemia and increased 5-HT function. The opposing responses in CFS and depression may be related to reversed patterns of behavioural dysfunction seen in these conditions. These findings attest to biological distinctions between these disorders.

References (25)

V. O'Keane et al.
d-fenfluramine-induced prolactin and cortisol release in major depression: response to treatment
J. Affect. Disord.
(1992)
L. Altomonte et al.
Effects of fenfluramine on GH and PRL secretion in obese subjects
Hormone Res.
(1987)
A.M.O. Bakheit et al.
Possible upregulation of hypothalamic 5-hydroxytryptamine receptors in patients with postviral fatigue syndrome
Br. Med. J.
(1992)
S.A. Checkley
Neuroendocrine tests of monoamine function in man: a review of basic theory and its application to the study of depressive illness
Psychol. Med.
(1980)
E. De Kloet et al.
Selective control by corticosterone of serotonin-1 receptors capacity in raphe-hippocampal system
Neuroendocrinology
(1986)
J.F.W. Deakin et al.
A neuroendocrine study of 5-HT function in depression: evidence for biological mechanisms of endogenous and psychosocial causation
Psychopharmacology
(1990)
C. Delbende et al.
Glucocorticoids, transmitters and stress
Br. J. Psychiatry
(1992)
M.A. Demitrack et al.
Evidence for impaired activation of the hypothalamic-pituitaryadrenal axis in patients with chronic fatigue syndrome
J. Clin. Endocrinol. Metab.
(1991)
T.G. Dinan
Glucocorticoids and the genesis of depressive illness
Br. J. Psychiatry
(1994)
S. Feeney et al.
The prolactin response to d-and l-fenfluramine and to d-amphetamine in human subjects
Int. Clin. Psychopharmacol.
(1993)

K. Fekuda et al.

The chronic fatigue syndrome: a comprehensive approach to its definition and study

Ann. Intern. Med.

(1994)

E.M. Goodall et al.

Ritanserin attenuates anorectic, endocrine and thermic responses to d-fenfluramine in human volunteers

Psychopharmacology

(1993)

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Barnden and colleagues, for example, showed that CFS presented with significant midbrain white matter abnormalities compared to controls, and that these abnormalities were linked with disease duration in the CFS group (Barnden et al., 2011), while a recent fMRI study showed a correlation between functional alterations of midbrain activity and mental fatigue, which was modulated by acute dopaminergic challenges or by chronic cocaine use (Moeller et al., 2012). Our results seem also in line with the reported dysregulation of serotoninergic tone observed in CFS patients, as shown by some fenfluramine challenge studies (but not by all; see for a review Parker et al., 2001), which pointed to an increased serotoninergic tone in CFS patients compared to controls (Cleare et al., 1995; Sharpe et al., 1997, Parker et al., 2001). We believe that our findings of a positive effect of agomelatine on fatigue in CFS, potentially mediated by inhibition of 5HT-2C receptors, points to the possibility to integrate in a single theoretical frame-work of disordered brainstem serotoninergic transmission, the aforementioned observations of midbrain structural and functional abnormalities and serotoninergic imbalance in CFS.
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Research reportContrasting neuroendocrine responses in depression and chronic fatigue syndrome

Abstract

J. Affect. Disord.

Effects of fenfluramine on GH and PRL secretion in obese subjects

Hormone Res.

Possible upregulation of hypothalamic 5-hydroxytryptamine receptors in patients with postviral fatigue syndrome

Br. Med. J.

Neuroendocrine tests of monoamine function in man: a review of basic theory and its application to the study of depressive illness

Psychol. Med.

Selective control by corticosterone of serotonin-1 receptors capacity in raphe-hippocampal system

Neuroendocrinology

A neuroendocrine study of 5-HT function in depression: evidence for biological mechanisms of endogenous and psychosocial causation

Psychopharmacology

Glucocorticoids, transmitters and stress

Br. J. Psychiatry

Evidence for impaired activation of the hypothalamic-pituitaryadrenal axis in patients with chronic fatigue syndrome

J. Clin. Endocrinol. Metab.

Glucocorticoids and the genesis of depressive illness

Br. J. Psychiatry

The prolactin response to d-and l-fenfluramine and to d-amphetamine in human subjects

Int. Clin. Psychopharmacol.

The chronic fatigue syndrome: a comprehensive approach to its definition and study

Ann. Intern. Med.

Ritanserin attenuates anorectic, endocrine and thermic responses to d-fenfluramine in human volunteers

Psychopharmacology

Research report
Contrasting neuroendocrine responses in depression and chronic fatigue syndrome