This might shed some light on the complexity of the brain.Juan Lopez, M.D., is an Associate Professor in the Department ofPsychiatry, and an Assistant Research Scientist in the Mental HealthResearch Institute of the University of Michigan. Dr. Lopez hasclinical expertise in the diagnosis and treatment of mood disorders,and his research area involves the effects of stress hormones andantidepressants on the brain. His talk was entitled "Stress andAntidepressant Modulation of the Limbic-Hypothalamic-Pituitary-Adrenal Axis."Juan discussed experiments in rats in which the effects of stressand antidepressant drugs on the regulation of corticosteroid andserotonin receptors in the brain were studied. He found thatantidepressants prevented the downregulation of corticosteroidreceptors and the changes in serotonin receptors that were caused bystress. He also found that tricyclic antidepressants (TCAs) weremore effective than selective serotonin reuptake inhibitors (SSRIs)for this purpose.I think that the main value of this type of work for CFS is that itsheds some light on the interaction between the HPA axis and theneurotransmitters in the brain. We know that there areabnormalities in both the HPA axis and the serotonin system in CFS.I suspect that the HPA axis is upregulated for a long time prior toonset in many of the cases of sudden onset of CFS, as a result of along-term load of various stressors. Later in the illness, the HPAaxis appears to be downregulated or blunted. On the other hand,there is evidence in the literature for upregulation of theserotonergic system in many PWCs. These characteristics appear tobe opposite to what is observed in major depression, where theglucocorticoid levels are found to be high, and benefit is foundfrom drugs that raise the serotonin levels. In "pure" CFS, I don'tthink antidepressant drugs have been found to be very helpful, andthese opposite characteristics from major depression may be thereason. By contrast, in "pure" fibromyalgia there is evidence forlow serotonergic activity, and SSRI antidepressants have often beenfound to be helpful for alleviating pain in this disorder.Rich Van Konynenburg --------------------------------------------- Too much mail? Try a digest version. See http://www.co-cure.org/digest.htm Send posts to mailto:CO-CURE###listserv.nodak.edu Join or leave the list at http://www.co-cure.org/sub.htm ---------------------------------------------tom