Cholinergic drugs as diagnostic and therapeutic tools in affective disorders

Abstract

The hypothesis of a significant involvement of the cholinergic system in the pathogenesis of affective disorders still lacks strong experimental support. This is mainly because of missing specific peripheral markers of the central nervous activity of the cholinergic system and the lack of specific cholinergic agonists and antagonists without severe peripheral side effects. As the direct cholinergic agonist RS 86 seems to be more suitable because of its minor side effects, long half‐life and oral applicability, it was tested for its antimanic property and its effect on the hypothalamo‐pituitary adrenal system and the rapid eye movement (REM) sleep‐generating system. RS 86 exhibited antimanic and REM sleep‐inducing properties, but failed to stimulate the Cortisol system.

Sleep, depression and antidepressants

“…In contrast to the original study with arecoline (Sitaram et al, 1982), Berger et al (1989) did not find a positive effect in depressive patients in remission. In another study Berger et al (1991) could not demonstrate a significant difference in RS 86-induced sleep onset REMS periods between patients with schizophrenic disorders and patients with depression. The pronounced shortening of REMS latency in the schizophrenic patients mainly occurred in the subjects with a chronic course of the disorder or a secondary depression.…”