Is adrenal response after trauma affected by time after trauma and sedative/analgesic drugs?
Total serum cortisol, calculated free cortisol, DHEA and DHEAS decreased significantly over time after trauma. Continuous infusion of sedative/analgesic drugs was independently associated with serum cortisol < 200 nmol/L.
If we take into account baseline values of mental and physical fatigue as well as the severity of this symptom in our study series, one observes that therapy with IFN alone induces fatigue in the majority of cases after 1 and 3 months, while at month 6, the values decrease. In contrast, patients treated with IFN + carnitine show a marked and early significant reduction of fatigue levels. These data suggest that the greater energetic substrate utilised by group 2 patients may in some way provide a better response of the patients to this side-effect. Abnormalities of neurotransmission concerning serotonine seem involved in the genesis of depression and fatigue. In addition, depression and fatigue commonly occur together, and the former is the most commonly observed symptom in patients with chronic fatigue syndrome.