The Effects of Galantamine Hydrobromide Treatment on DHEA-S & Cortisol Levels in CFS

Dolphin

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(Note that I had to shortened the title slightly to get it to fit: "The Effects of Galantamine Hydrobromide Treatment on Dehydroepiandrosterone Sulfate and Cortisol Levels in Patients with Chronic Fatigue Syndrome")

The Effects of Galantamine Hydrobromide Treatment on Dehydroepiandrosterone Sulfate and Cortisol Levels in Patients with Chronic Fatigue Syndrome.

Journal: Psychiatry Investig. 2009 Sep;6(3):204-210. Epub 2009 Jun 23.

Authors: Turan T, Izgi HB, Ozsoy S, Tanriverdi F, Basturk M, Asdemir A, Besirli A, Esel E, Sofuoglu S.

Affiliation: Department of Psychiatry, Erciyes University Medical School, Kayseri, Turkey.

NLM Citation: PMID: 20046396


OBJECTIVE: Mental fatigue, cognitive disorders, and sleep disturbances seen in chronic fatigue syndrome (CFS) may be attributed to cholinergic deficit. A functional deficiency of cholinergic neurotransmission may cause the hypothalamic-pituitary-adrenal axis hypoactivity seen in CFS. Therefore, we investigated the alterations in stress hormones such as cortisol and dehydroepiandrosterone sulfate (DHEAS) in CFS patients before and after 4-week administration of galantamine hydrobromide, a selective acetylcholinesterase inhibitor, and aimed to investigate whether there are any relationships between the probable hormonal changes and cholinergic treatment.

METHODS: Basal levels of cortisol and DHEAS were measured in 29 untreated CFS patients who were diagnosed according to Centers for Disease Control (CDC) criteria and in 20 healthy controls. In the patient group, four weeks after 8 mg/d galantamine hydrobromide treatment, cortisol and DHEAS levels were measured again. After the treatment 22 patients who stayed in study were divided into two subgroups as responders and nonresponders according to the reduction in their Newcastle Research Group ME/CFS Score Card (NRG) scores.

RESULTS: Important findings of this study are lower pre-and post-treatment cortisol levels and in all CFS patients compared to controls (F=4.129, p=0.049; F=4.803, p=0.035, respectively); higher basal DHEAS values and higher DHEAS/cortisol molar ratios which were normalized following four weeks' treatment with 8 mg/d galantamine hydrobromide in the treatment-respondent group (F=5.382, p=0.029; F=5.722, p=0.025, respectively).

CONCLUSION: The findings of the decrease in basal DHEAS levels and DHEAS/cortisol molar ratios normalizing with galantamine treatment may give some support to the cholinergic deficit hypothesis in CFS.

Note: The full text of this article is available for free at http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2796068/
 

Dolphin

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A few extra points. A few people dropped out also:
However, seven patients were later excluded as they were unable to tolerate the treatment because of nausea or would not agree to cooperate, and the study continued with 22 patients.
They refer to a lot of the other HPA axis research. There have been contrasting findings.

If anyone is curious:
Newcastle Research Group ME/CFS Score Card (NRG),32 which consists of 10 items and measures the physical and cognitive functions, and on which a score of ≥15 is highly suggestive of CFS.

[..]

32. Richardson J. Myalgic encephalomyelitis: guidelines for doctors. Journal of Chronic Fatigue Syndrome 2002;10:65-80.
Dr Richardson followed ME patients for decades. It's the first time I've seen the scale being used by others. I haven't looked at it but it could be better than some of the scales that are sometimes used.

Tables 1-4 give pretty much all the info one needs. If one looks at Table 4, one can see that DHEA-S and the DHEA-S/cortisol ratio clearly was going back towards normal in the responders group.
The researchers say perhaps cortisol would have increased if the trial had been longer but that is just speculation.