Blunted serotonin-mediated activation of the hypothalamic-pituitary-adrenal axis in Chronic Fatigue Syndrome (CFS)

We examined 5HT1a-mediated ACTH release in patients with chronic
fatigue syndrome (CFS) using a between-subjects design.
Patients attending a specialist outpatient clinic for CFS, who
fulfilled CDC criteria, together with age- and sex-matched
healthy comparison subjects, were recruited. Subjects had a
cannula inserted in a forearm vein at 0830 h and were allowed
to relax until 0900 h, when baseline bloods for ACTH and
cortisol were drawn. They were then given ipsapirone 20 mg PO
and further blood for hormone estimation was taken at +30,
+60, +90, +120 and +180 min. Baseline ACTH and cortisol levels
did not differ between the two groups. Release of ACTH (but
not cortisol) in response to ipsapirone challenge was
significantly blunted in patients with CFS. We conclude that
serotonergic activation of the hypothalamic-pituitary-adrenal
axis is defective in CFS. This defect may be of
pathophysiological significance.

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