Differential response of rapid eye movement sleep to cholinergic blockade by scopolamine in currently depressed, remitted, and normal control subjects.
The degree of cholinergic dysregulation of sleep in adult depression was evaluated using scopolamine. On separate sessions, placebo and scopolamine (4.5 micrograms/kg, IM) were administered to 14 patients with unipolar major depression, 16 recovered/remitted patients, and 18 normal controls. Scopolamine increased rapid eye movement (REM) latency (RL), reduced REM activity (RA), REM density (RD), and REM duration, and increased the percentage of stage 4 sleep in all groups. There was a differential effect of scopolamine on RL, RA, and REM duration for the first REM period, and on percentage of stage 4 sleep. Whereas a primary cholinergic hyperactivity could account for the RA and RD responses, the response profile for RL was more compatible with reduced aminergic tone as the proximal cause of the cholinergic hyperactivity. Whether the sleep abnormalities observed in remitted patients reflect an underlying vulnerability for development or recurrence of depression, and/or a scar, remains to be determined.
Poland
R E
RE
Department of Psychiatry, Harbor-UCLA Medical Center, Torrance 90509, USA.
McCracken
J T
JT
Lutchmansingh
P
P
Lesser
I M
IM
Tondo
L
L
Edwards
C
C
Boone
K B
KB
Lin
K M
KM
D000328:Adult; D000368:Aged; D000928:Antidepressive Agents / Q000627:therapeutic use; D003866:Depressive Disorder / Q000175:diagnosis* / Q000188:drug therapy / Q000503:physiopathology; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D018727:Muscarinic Antagonists; D017286:Polysomnography / Q000187:drug effects; D011930:Reaction Time / Q000187:drug effects / Q000502:physiology; D011950:Receptors, Cholinergic / Q000187:drug effects* / Q000502:physiology; D012008:Recurrence; D012307:Risk Factors; D012601:Scopolamine; D012895:Sleep, REM / Q000187:drug effects* / Q000502:physiology
D000928:Antidepressive Agents; D018727:Muscarinic Antagonists; D011950:Receptors, Cholinergic; D012601:Scopolamine