We’re all too aware that it can take at least three weeks before realizing measurable benefit from antidepressant therapy. And the wait can be excruciating. But maybe that won’t be the case in the not too distant future.
Before we get to the heart of our subject matter we need to lay a foundation…
- Glutamic acid (glutamate) is receiving more and more attention as a treatment target for depression; stealing the glory from serotonin and norepinephrine. Glutamate is the most common neurotransmitter in the brain and its functioning almost always is excitatory in character.
- Acetylcholine, a central nervous system neurotransmitter, is huge in neuroplasticity, arousal, reward, sensory perception upon awakening, and sustaining attention.
- Research conducted several years ago revealed ketamine provided relief from treatment-resistant depression within hours of injection. Ketamine is an N-Methyl-D-Aspartate (NMDA) glutamate receptor antagonist.
Okay, now we’re ready to get down to business. Please allow me to introduce scopolamine (Scopace, Transderm-Scop). The latest issue of Biological Psychiatry shared the news that researchers from the National Institutes of Health (NIH) have discovered the administration of scopolamine generates a very quick elevation of mood.
Scopolamine is obtained from plants of the Solanaceae family, and it has anticholinergic properties. And that means it works against the activity of acetylcholine. In the medical world, scopolamine is primarily used to treat nausea and intestinal cramping. It’s frequently delivered through a transdermal patch. It’s very powerful medicine and if not dosed correctly can generate confusion, agitation, rambling speech, hallucinations, paranoid behaviors, and delusions. In fact, it’s been confirmed that the Czechoslovak communist secret police used it several times last year to secure confessions from supposed anti-state conspirators.
In a double-blind study, Drs. Wayne Drevets and Maura Furey found that the administration of scopolamine reduced symptoms of depression within three days of the first dose, and a degree of relief was actually noted the following morning. There’s more – half of the subjects experienced full symptom remission by the end of the treatment period. And if that wasn’t enough, the subjects remained well during a placebo period that followed. That’s called lasting power.
Among many things, what’s very interesting here is the fact that scopolamine’s target, the muscarinic receptors, is the very same target used by the original antidepressants, the tricyclics (TCAs). Now, the SSRIs and SSNRIs were designed to avoid these receptors because it was thought they were responsible for unwanted side effects, such as constipation, sedation, and memory loss. But our new research indicates the strategy may well have backfired in that it succeeded in reducing unpleasant side effects; however, there was also a dramatic decrease in treatment efficacy. Oops!
Now, as hopeful as this research is, it still remains to be seen if this high-speed depression relief business will hold up clinically. So, obviously, much work remains. But no matter how you slice it the research is encouraging if for no other reason than it indicates cutting edge depression relief research is being conducted.
So there appears to be a degree of new hope in terms of treatment for depression. But is this simply a “grab-a-neurotransmitter” wild goose chase? Are meds even the ultimate answer? Would you be willing to participate in such research? Please help us all with your comments.