Posted by SLS on October 6, 2006, at 7:19:33
This might be worth taking a look at. There is a rationale for using an antimuscarinic anticholinergic like scopolamine to treat depression. I tried biperiden (Akineton). It didn't help, but that's just me. If it works as rapidly as is claimed here, maybe an anticholinergic is worth a quick trial.
- Scott
--------------------------------------------------------------------------------Scopolamine May Help Reduce Symptoms of Major Depression CME
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Medscape:
News Author: Laurie Barclay, MD
CME Author: Charles Vega, MD, FAAFPOctober 4, 2006 — Scopolamine therapy is effective in reducing depressive symptoms in patients with major depression, according to the results of a randomized controlled trial reported in the October issue of the Archives of General Psychiatry.
"The need for improved therapeutic agents that more quickly and effectively treat depression is critical," write Maura L. Furey, PhD, and Wayne C. Drevets, MD, from the National Institute of Mental Health in Bethesda, Maryland. "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 (4 µg/kg intravenously) compared with placebo (P = .002). Subsequently a clinical trial was designed to assess more specifically the antidepressant efficacy of scopolamine."
The investigators conducted 2 studies at the National Institute of Mental Health: a double-blind, placebo-controlled, dose-finding study, followed by a double-blind, placebo-controlled, crossover clinical trial.
Of 39 eligible patients, currently depressed outpatients aged 18 to 45 years meeting the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) criteria for recurrent major depressive disorder or bipolar disorder, 19 were randomized and 18 completed the study. Subjects underwent multiple sessions 3 to 5 days apart, including intravenous infusions of placebo or 4 µg/kg of scopolamine, and they were randomized to a placebo/scopolamine or scopolamine/placebo sequence (series of 3 placebo sessions and series of 3 scopolamine sessions). The primary endpoints were psychiatric evaluations using the Montgomery-Asberg Depression Rating Scale and the Hamilton Anxiety Rating Scale.
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 < .001 for both) after the administration of scopolamine compared with placebo. The scopolamine/placebo group also had reduced depression and anxiety rating scale scores (P < .001 for both) relative to baseline after receiving scopolamine, and these effects persisted as they received placebo. Both groups showed improvement at the first evaluation after scopolamine administration (P = .002).
"Rapid, robust antidepressant responses to the antimuscarinic scopolamine occurred in currently depressed patients who predominantly had poor prognoses," the authors write. "Determination of the optimal schedule of administration and the potential long-term use of scopolamine as an antidepressant agent requires further study, particularly because potential adverse effects include confusion and delirium. Future studies also may examine the antidepressant efficacy of scopolamine when using routes of administration that are more clinically practical in outpatient settings."
The National Institute of Mental Health, National Institutes of Health, supported this study. A use-patent application for the use of scopolamine as an antidepressant agent has been filed.
Arch Gen Psychiatry. 2006;63:1121-1129.
poster:SLS
thread:692331
URL: http://www.dr-bob.org/babble/20061003/msgs/692331.html