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Antidepressant Efficacy of the Antimuscarinic Drug Scopolamine

2006; American Medical Association; Volume: 63; Issue: 10 Linguagem: Inglês

10.1001/archpsyc.63.10.1121

1538-3636

Maura L. Furey, Wayne C. Drevets,

Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes

Context:The need for improved therapeutic agents that more quickly and effectively treat depression is critical.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.Objective: To evaluate scopolamine as a potential antidepressant agent.Design: Two studies were conducted: a double-blind, placebo-controlled, dose-finding study followed by a double-blind, placebo-controlled, crossover clinical trial.Setting: The National Institute of Mental Health.Patients: Currently depressed outpatients aged 18 to 50 years meeting DSM-IV criteria for recurrent major depressive disorder or bipolar disorder.Of 39 eligible patients, 19 were randomized and 18 completed the trial.Interventions: Multiple sessions including intravenous infusions of placebo or scopolamine hydrobromide (4 µg/kg).Individuals were randomized to a placebo/ scopolamine or scopolamine/placebo sequence (series of 3 placebo sessions and series of 3 scopolamine sessions).Sessions occurred 3 to 5 days apart.Main Outcome Measures: Psychiatric evaluations using the Montgomery-Asberg Depression Rating Scale and the Hamilton Anxiety Rating Scale were performed to assess antidepressant and antianxiety responses to scopolamine.