Preprint Stress-Related Chronic Fatigue Syndrome: A Case Report with Positive Response to Alpha-Methyl-P-Tyrosine (AMPT) Treatment, 2024, Ljungström

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https://www.preprints.org/manuscript/202406.1544/v1

Stress-Related Chronic Fatigue Syndrome: A Case Report with Positive Response to Alpha-Methyl-P-Tyrosine (AMPT) Treatment
Maria Ljungström
Elisa Oltra
Marta Pardo
*

Version 1 : Received: 21 June 2024 / Approved: 21 June 2024 / Online: 21 June 2024

How to cite: Ljungström, M.; Oltra, E.; Pardo, M. Stress-Related Chronic Fatigue Syndrome: A Case Report with Positive Response to Alpha-Methyl-P-Tyrosine (AMPT) Treatment. Preprints 2024, 2024061544.

Abstract

Alpha-methyl-p-tyrosine (AMPT; also referred as metyrosine) is an approved medication for the treatment of pheochromocytoma.

As a tyrosine hydroxylase inhibitor AMPT may be a potential candidate for the treatment of diseases involving catecholamine alterations.

However, only small-scale clinical trials have tested AMPT repurposing in few other illnesses.

Chronic fatigue syndrome (CFS) is an heterogenous disorder with genetically associated vulnerability of catecholamine metabolism (e.g. catechol O-methyltransferase polymorphisms) holding an important impact of environmental factors.

The current case report compiles genetic and longitudinal biochemical data for over a year follow-up of one patient sequentially diagnosed with sustained overstress, neurasthenia, CFS, and POTS (postural orthostatic tachycardia syndrome) over a 10-year period, and reports patient’s symptom improvement in response to low-medium doses of AMPT.

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Abstract

Chronic fatigue syndrome (CFS) is a heterogeneous disorder with a genetically associated vulnerability of the catecholamine metabolism (e.g., catechol O-methyltransferase polymorphisms), in which environmental factors have an important impact. Alpha-methyl-p-tyrosine (AMPT; also referred to as metyrosine) is an approved medication for the treatment of pheochromocytoma. As a tyrosine hydroxylase inhibitor, AMPT may be a potential candidate for the treatment of diseases involving catecholamine alterations. However, only small-scale clinical trials have tested AMPT repurposing in a few other illnesses. The current case report compiles genetic and longitudinal biochemical data for over a year of follow-up of a male patient sequentially diagnosed with sustained overstress, neurasthenia, CFS (diagnosed in 2012 as per the Center for Disease Control (CDC/Fukuda)), and postural orthostatic tachycardia syndrome (POTS) over a 10-year period and reports the patient’s symptom improvement in response to low–medium doses of AMPT. This case was recognized as a stress-related CFS case. Data are reported from medical records provided by the patient to allow a detailed response to treatment targeting the hyperadrenergic state presented by the patient.

We highlight the lack of a positive response to classical approaches to treating CFS, reflecting the limitations of CFS diagnosis and available treatments to alleviate patients’ symptoms. The current pathomechanism hypothesis emphasizes monoamine alterations (hyperadrenergic state) in the DA/adrenergic system and a dysfunctional autonomic nervous system resulting from sympathetic overactivity. The response of the patient to AMPT treatment highlights the relevance of pacing with regard to stressful situations and increased activity. Importantly, the results do not indicate causality between AMPT and its action on the monoamine system, and future studies should evaluate the implications of other targets.

Open access, https://www.mdpi.com/1422-0067/25/14/7778
 
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