title: No antidepressant effect of biperiden compared with placebo in depression: a double-blind 6-week clinical trial.
abstract: Depression may result from an increased ratio of cholinergic to aminergic central neurotransmission. The effect of centrally active anticholinergic agents on depressive ratings in depressed patients, however, has not been well studied. In a previous open label 4-week clinical trial, Kasper et al. (1981) reported that biperiden (Akineton) had antidepressant effects in depressed patients. We compared the effects of placebo and biperiden in a randomized, double-blind, parallel-design 6-week study. All patients received placebo for the first week and then received either biperiden (< or = 12 mg/day) or a peripherally acting anticholinergic agent, glycopyrrolate (Robinul, 1 mg/day) for 4 weeks. All patients received placebo during week 6. Both groups significantly improved, but biperiden did not demonstrate any significant benefit compared with glycopyrrolate. In a subgroup of patients receiving biperiden, the percentage of rapid eye movement sleep was significantly decreased only in the first week of biperiden compared with the initial placebo week, suggesting that tolerance to the central effects of biperiden developed. Further studies would be needed to determine whether anticholinergic agents possess antidepressant properties.
authors.affiliation: Department of Psychiatry, University of California, San Diego, USA.
authors.forename: J C
authors.initials: JC
authors.lastname: Gillin
authors.forename: J
authors.initials: J
authors.lastname: Lauriello
authors.forename: J R
authors.initials: JR
authors.lastname: Kelsoe
authors.forename: M
authors.initials: M
authors.lastname: Rapaport
authors.forename: S
authors.initials: S
authors.lastname: Golshan
authors.forename: W M
authors.initials: WM
authors.lastname: Kenny
authors.forename: L
authors.initials: L
authors.lastname: Sutton
mesh_terms: D000328:Adult; D001712:Biperiden / Q000009:adverse effects / Q000627:therapeutic use*; D003866:Depressive Disorder / Q000188:drug therapy* / Q000523:psychology; D004311:Double-Blind Method; D005260:Female; D006024:Glycopyrrolate / Q000009:adverse effects / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D018727:Muscarinic Antagonists / Q000009:adverse effects / Q000627:therapeutic use*; D010555:Personality Inventory; D012895:Sleep, REM / Q000187:drug effects
chemical_list: D018727:Muscarinic Antagonists; D001712:Biperiden; D006024:Glycopyrrolate