Scopolamine is an effective and rapid antidepressant in both unipolar and bipolar depression , working as quickly as 3 days after initial infusion .
OBJECTIVES The cholinergic-adrenergic hypothesis of mania and depression states that depression is characterized by an increase in central cholinergic activity relative to noradrenergic tone .
Scopolamine is a central ly acting competitive inhibitor of the muscarinic cholinergic receptor site .
This review seeks to find all available data investigating scopolamine as an antidepressant .
Hypothalamo–pituitary–adrenal cortical responses to low-dose physostigmine and arginine vasopressin administration: sex differences between major depressives and matched control subjects
Of heuristic value in underst and ing the neurochemistry of major depression is whether the hypothalamo-pituitary-adrenocortical ( HPA ) axis hyperactivity that occurs in this illness can be related to putative neurotransmitter dysfunction(s ) . Cholinergic neurotransmission stimulates hypothalamic corticotropin releasing hormone ( CRH ) and arginine vasopressin ( AVP ) secretion , both of which stimulate pituitary corticotropin ( ACTH ) secretion , but whether the HPA axis in humans is activated only by doses of cholinergic agonists that produce noxious side effects remains controversial . To test the hypothesis of increased cholinergic sensitivity in major depression , physostigmine ( PHYSO ) , a reversible cholinesterase inhibitor , was administered to patients and control subjects at a dose that elevated plasma ACTH , cortisol , and AVP concentrations but produced few or no side effects . Exogenous AVP also was administered to determine if it would augment the effect of low-dose PHYSO on the HPA axis . Twelve premenopausal or estrogen-replaced female major depressives , 12 individually matched female control subjects , eight male major depressives , and eight matched male control subjects underwent four test sessions 5 - 7 days apart : PHYSO ( 8 microg/kg IV ) , AVP ( 0.08 U/kg IM ) , PHYSO + AVP , and saline control . Serial blood sample s were taken before and after pharmacologic challenge and analyzed for ACTH1 - 39 , cortisol , and AVP . Estradiol and testosterone were also measured at each test session . PHYSO ( 8 microg/kg ) significantly increased plasma ACTH , cortisol , and AVP , while producing no side effects in approximately half the subjects and predominantly mild side effects in the other half . These hormone increases following PHYSO occurred primarily in the female depressives and the male control subjects and were not significantly related to the presence or absence of side effects . The greater the ACTH and AVP responses to PHYSO , the stronger their correlation , suggesting that AVP may have been acting as a secretagogue for ACTH . Administered AVP significantly increased the secretion of ACTH in the patients and control subjects to a similar degree , and AVP given after PHYSO did not augment the HPA axis response to a greater degree in the depressives than in the control subjects . Plasma estradiol and testosterone were within the normal range for all four groups of subjects and were not significantly related to their HPA axis hormone responses . The study results support the hypothesis of heightened cholinergic sensitivity in premenopausal female , but not in male , patients with major depression . The low dose of PHYSO used may represent a useful paradigm for central cholinergic stimulation of the HPA axis
Scopolamine is an effective and rapid antidepressant in both unipolar and bipolar depression , working as quickly as 3 days after initial infusion .
OBJECTIVES The cholinergic-adrenergic hypothesis of mania and depression states that depression is characterized by an increase in central cholinergic activity relative to noradrenergic tone .
Scopolamine is a central ly acting competitive inhibitor of the muscarinic cholinergic receptor site .
This review seeks to find all available data investigating scopolamine as an antidepressant .