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Psychosomatic Medicine 36:248-257 (1974)
© 1974 American Psychosomatic Society

Acetylcholine and Depression

DAVID S. JANOWSKY MD1, M. KHALED EL-YOUSEF MD1, and JOHN M. DAVIS MD1

1 Departments of Psychiatry and Pharmacology, the Vanderbilt University School of Medicine, Nashville, Tennessee, the Illinois Psychiatric Institute Chicago, Illinois and the Department of Psychiatry, University of California at San Diego School of Medicine, San Diego, California

Address for reprint requests: David S. Janowsky, MD, Department of Psychiatry, University of California at San Diego, School of Medicine, La Jolla, California 92037

Physostigmine, a cholinesterase inhibitor which increases central acetylcholine levels, has been found in man to decrease manic symptoms, antagonize methylphenidate-induced behavioral activation, and induce severe depression and psychomotor retardation in marijuana intoxicated normals. In the current study, physostigmine was found to increase depressed mood in patients with an affective component to their symptoms (manics, depressives, and schizoaffectives). Schizophrenics without an affective component did not become depressed. After physostigmine administration, all subject groups showed a significant increase in symptoms including lethargy, slowed thoughts, withdrawal, apathy, decreased energy, decreased thoughts, motor retardation, and feeling drained, indicating a state of psychomotor retardation; and all became less cheerful, friendly, and talkative. The above information is compatible with the hypothesis that acetylcholine may be involved in the etiology of affective disorders.

Submitted on April 30, 1973
Revised on November 23, 1973




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