Advertisement

The effects of scopolamine on sleep and mood in depressed patients with a history of alcoholism and a normal comparison group

      This paper is only available as a PDF. To read, Please Download here.

      Abstract

      In order to determine the effect of an anticholinergic agent on mood and sleep, scopolamine (0.4 mg IM) was administered before bedtime for three consecutive nights to 10 depressed patients (8 with a history of alcohol abuse) and 10 normal comparison subjects. The patients had a small, statistically significant antidepressant response on the second morning of treatment. Scopolamine inhibited rapid eye movement (REM) sleep and prolonged REM latency equally in depressed patients and the normal comparison group. Partial tolerance to the REM inhibiting effect of scopolamine developed between the first and third night of treatment. A REM rebound occurred during recovery nights. These results are consistent with concepts relating central cholinergic mechanisms to the control of REM sleep. Compared with controls, patients showed a greater increase in Stage 2 and Stage 2% and a lesser and increase in Delta (Stage 3 and 4) sleep % and Stage 4% on the first night of treatment. Further, well-controlled studies are needed to determine whether anticholinergic drugs possess clinically significant antidepressant effects.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Biological Psychiatry
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Abood L.C.
        • Meduna L.L.
        Some effects of a new psychotogen in depressive states.
        J Nerv Ment Dis. 1958; 127: 546-550
        • Baghdoyan H.A.
        • Lydic R.
        • Callaway C.W.
        • Hobson J.A.
        The carbachol-induced enhancement of desynchronized sleep signs is dose dependent and antagonized by centrally administered atropine.
        Neuropsychopharmacology. 1989; 2: 67-79
        • Bercel N.A.
        Clinical experience with a new type of antidepressant drug: Ditran.
        J Neuropsychiatry. 1961; 2: 227-228
        • Berger M.
        • Riemann D.
        • Hoechli D.
        • Spiegel R.
        The cholinergic REM sleep induction test with RS 86: State or trait-marker of depression?.
        Arch Gen Psychiatry. 1989; 46: 421-428
        • Borbély A.A.
        The S-deficiency hypothesis of depression and the two process model of sleep regulation.
        Pharmacopsychiatry. 1987; 20: 23-39
        • Buzsaki G.
        • Bickford R.G.
        • Ponomareff G.
        • Thal L.J.
        • Mandel R.
        • Gage F.H.
        Nucleus basalis and thalamic control of neocortical activity in the freely moving rat.
        J Neurosci. 1988; 8: 4007-4026
        • Dilsaver S.C.
        • Snider R.M.
        • Greden J.F.
        Antidepressant withdrawal syndromes: Phenomenology and pathophysiology.
        Int Clin Psychopharmacol. 1987; 2: 1-19
        • Finkelstein B.
        Ditran, a psychotherapeutic advance: A review of one hundred and three cases.
        J Neuropsychiatry. 1961; 2: 144-148
        • George R.
        • Haslett W.L.
        • Jenden D.J.
        A cholinergic mechanism in the pontine reticular formation: Induction of paradoxical sleep.
        Int J Neuropharmacol. 1964; 3: 541-552
        • Gillin J.C.
        • Sitaram N.
        • Wehr T.
        • et al.
        Sleep and affective illness.
        in: Post R.M. Ballenger J. Neurobiology of Mood Disorders. William and Wilkins, Baltimore1984: 157-189
        • Gillin J.C.
        • Kelsoe J.R.
        • Kaufman C.A.
        • et al.
        Muscarinic receptor density in skin fibroblasts and autopsied brain tissue in affective disorder.
        in: Psychobiology of Suicidal Behavior. 487. Annals of the New York Academy of Science, New York1986: 143-149
        • Gillin J.C.
        • Janowsky D.J.
        • Risch S.C.
        • Kripke D.F.
        The effects of brief naps on mood and sleep in sleep-deprived depressed patients.
        Psychiatry Res. 1989; 27: 253-265
        • Gillin J.C.
        • Sutton L.
        • Ruiz C.
        • et al.
        The cholinergic REM induction test with arecoline in depression.
        Arch Gen Psychiatry. 1991; 48: 264
        • Gillin J.C.
        • Sutton L.
        • Ruiz C.
        • et al.
        Dose dependent inhibition of REM sleep in normal controls by biperiden, a muscarinic agonist.
        Biol Psychiatry. 1991; 30: 151-156
        • Gnadt J.W.
        • Pegram G.V.
        Cholinergic brainstem mechanisms of REM sleep in the rat.
        Brain Res. 1986; 384: 29-41
        • Janowsky D.S.
        • El-Youseff M.K.
        • Davis J.M.
        A cholinergic-adrenergic hypothesis of mania and depression.
        Lancet. 1972; 2: 632
        • Jellinec T.
        • Gardos G.
        • Cole J.
        Adverse effects of antiparkinsonian drug withdrawal.
        Am J Psychiatry. 1981; 138: 1567-1571
        • Jouvet M.
        Cholinergic mechanisms and sleep.
        in: Waser P.G. Cholinergic Mechanisms. Raven Press, New York1975: 455-476
        • Kasper S.
        • Moises H.W.
        • Beckman H.
        The anticholinergic biperiden depressive disorders.
        Pharmacopsychiatry. 1981; 14: 195-198
        • Knowles J.B.
        • MacLean A.W.
        Age related changes in sleep in depressed and healthy subjects: A meta-analysis.
        Neuropsychopharmacology. 1990; 3: 251-259
        • Kupfer D.J.
        • Thace M.E.
        The use of the sleep laboratory in the diagnosis of affective disorders.
        Psychiatr Clin North Am. 1983; 6: 3-25
        • McCarley R.W.
        • Massaquoi S.G.
        A limit cycle mathematical model of the REM sleep oscillatory system.
        Am J Physiol. 1986; 251: R1011-R1029
        • Mitani A.
        • Ito K.
        • Mitani Y.
        • McCarley R.W.
        Morphological and Electrophysiological identification of gigantocellular tegmental field cells with descending projections in the cat. I Pons.
        J Comp Neurol. 1989; 268: 527-545
        • Newhouse P.A.
        • Sunderland T.
        • Tariot P.N.
        • et al.
        The effects of acute scopolamine in geriatric depression.
        Arch Gen Psychiatry. 1988; 45: 906-912
        • Poland R.E.
        • Tondo L.
        • Rubin R.T.
        • Trelease R.B.
        • Lesser J.M.
        Differential effects of scopolamine on nocturnal cortisol secretion, sleep architecture, and REM latency in normal volunteers: Relation to sleep and cortisol abnormalities in depression.
        Biol Psychiatry. 1989; 25: 403-412
        • Rechtschaffen A.
        • Kales A.
        A manual of standard techniques and scoring system for sleep stages in human subjects.
        in: HIH Publication #202. U.S. Government Printing Office, Washington, DC1971
        • Reynolds III, C.F.
        • Kupfer D.J.
        • Hoch C.C.
        • Stack J.A.
        • Houch P.A.
        • Berman S.R.
        Sleep deprivation effects on older endogenous depressed patients.
        Psychiatry Res. 1987; 21: 95-109
        • Sagales T.
        • Erill S.
        • Domino E.F.
        Effects of repeated doses of scopolamine on the electroencephalographic stages of sleep in normal volunteers.
        Clin Pharmacol Ther. 1975; 18: 727-732
        • Schuckit M.A.
        The clinical implications of primary diagnostic groups among alcoholics.
        Arch Gen Psychiatry. 1985; 42: 1043-1049
        • Shiromani P.J.
        • Armstrong D.J.
        • Gillin J.C.
        Cholinergic neurons from dorsolateral pons project to the medial pons: A WGA-HRP and choline acetyltransferase immunohistochemical study.
        Neuroscience Lett. 1988; 95: 19-23
        • Sitaram N.
        • Gillin J.C.
        Development and use of pharmacological probes of the CNS in man: Evidence for cholinergic abnormality in primary affective illness.
        Biol Psychiatry. 1980; 15: 925-955
        • Sutin E.
        • Shiromani P.
        • Kelsoe J.
        • Storch F.
        • Gillin J.C.
        Chronic scopolamine treatment increases REM sleep and muscarinic receptor binding during withdrawal.
        Life Sci. 1980; 39: 2419-2427
        • Velazquez-Moctezuma J.
        • Gillin J.C.
        • Shiromani P.
        The effect of M1 and M2 receptor agonists on REM sleep generation.
        Brain Res. 1989; 503: 128-131
        • Von Dongen P.A.M.
        • Broekamp C.L.E.
        • Cools A.R.
        Atonia after carbachol microinjections near the locus coeruleus in cats.
        Pharmacol Biochem Behav. 1978; 8: 527-532