Scopolamine May Help Reduce Symptoms Of Major Depression ?
Q: In a pilot study we evaluated the role of the
cholinergic system in cognitive symptoms of depression and unexpectedly
observed rapid reductions in depression severity following the
administration of the antimuscarinic drug scopolamine hydrobromide
A:Several lines of evidence suggest that acetylcholine has a role in the
etiology of depression. The administration of physostigmine, an
inhibitor of cholinesterase, can exacerbate depression, and patients
with depression experience exaggerated polysomnographic findings and
pupillary responses following administration of cholinergic
medications. These findings suggest that anticholinergic medications
may improve depression, but a controlled study of the anticholinergic
medication biperiden failed to demonstrate a significant benefit of
therapy.
In the current study, the authors report on the efficacy of scopolamine
in the management of depression and bipolar disorder. The study began
as an investigation of the effect of anticholinergic treatment on
cognition in depression, but the authors designed a randomized,
crossover trial after noting an improvement of depression scores
associated with scopolamine.
Compared with baseline, the placebo/scopolamine group had no
significant change during placebo infusion, but there were
reductions in depression and anxiety rating scale scores (P