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Since the publication of the serotonin hypothesis, numerous theories involving the accumulation or depletion of different substances in the brain have been proposed to explain central fatigue. Although the theoretical rationale for the "serotonin-fatigue hypothesis" is clear, several seemingly well-conducted studies have failed to support a significant role for 5-hydroxytryptamine in the development of fatigue. As brain function appears to be dependent upon the interaction of a number of systems, it is unlikely that a single neurotransmitter system is responsible for central fatigue. Several other mechanisms are involved, with evidence supporting a role for the brain catecholamines. Fatigue is therefore probably an integrated phenomenon, with complex interaction among central and peripheral factors. When prolonged and excessive training happens, concurrent with other stressors and insufficient recovery, performance decrements can result in chronic maladaptations that can lead to the overtraining syndrome (OTS). The mechanism of the OTS could be difficult to examine in detail, perhaps because the stress caused by excessive training load, in combination with other stressors, might trigger different "defence mechanisms" such as the immunological, neuroendocrine, and other physiological systems that all interact and probably therefore cannot be pinpointed as the "sole" cause of the OTS. It might be that, as in other syndromes, the psychoneuroimmunology (study of brain-behavior-immune interrelationships) might shed a light on the possible mechanisms of the OTS, but until there is a definite diagnostic tool, it is of utmost importance to standardize measures that are now thought to provide a good inventory of the training status of the athlete. It is very important to emphasize the need to distinguish the OTS from overreaching and other potential causes of temporary underperformance such as anemia, acute infection, muscle damage, and insufficient carbohydrate intake.