title: The effects of galantamine hydrobromide treatment on dehydroepiandrosterone sulfate and cortisol levels in patients with chronic fatigue syndrome.
abstract: 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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Psychiatry, Erciyes University Medical School, Kayseri, Turkey.
authors.forename: Tayfun
authors.initials: T
authors.lastname: Turan
authors.forename: Hasan Basri
authors.initials: HB
authors.lastname: Izgi
authors.forename: Saliha
authors.initials: S
authors.lastname: Ozsoy
authors.forename: Fatih
authors.initials: F
authors.lastname: Tanrıverdi
authors.forename: Mustafa
authors.initials: M
authors.lastname: Basturk
authors.forename: Akif
authors.initials: A
authors.lastname: Asdemir
authors.forename: Aslı
authors.initials: A
authors.lastname: Beşirli
authors.forename: Ertugrul
authors.initials: E
authors.lastname: Esel
authors.forename: Seher
authors.initials: S
authors.lastname: Sofuoglu