Newhouse P A, Sunderland T, Tariot P N, Weingartner H, Thompson K, Mellow A M, Cohen R M, Murphy D L
Department of Behavioral Biology, Walter Reed Army Institute of Research, Washington, DC.
Arch Gen Psychiatry. 1988 Oct;45(10):906-12. doi: 10.1001/archpsyc.1988.01800340028004.
In an intensive multidrug, multidose study, nine elderly depressed patients were administered 0.1, 0.25, and 0.5 mg of scopolamine hydrobromide, 1 mg of oral lorazepam, and placebo in a double-blind investigation aimed at assessing the status of the central cholinergic nervous system in geriatric depression. Significant cognitive and behavioral effects of scopolamine were observed only at the high dose (0.5 mg), while lower doses and lorazepam showed no significant differences from placebo. Cognitive deficits caused by scopolamine were in the areas of new learning, access to semantic memory, vigilance, and continuous performance. Behavioral effects consisted of activation, restlessness, and anxiety, but there was no significant effect on depressed mood. These results suggest that elderly depressed patients with mild to moderate cognitive impairment seem to be more similar to previously studied elderly controls rather than to patients with Alzheimer's disease in their reaction to short-term cholinergic blockade, and suggest that the cognitive and mood changes often seen in geriatric depression may involve factors other than disturbed muscarinic cholinergic mechanisms.
在一项多药物、多剂量的强化研究中，九名老年抑郁症患者在一项旨在评估老年抑郁症患者中枢胆碱能神经系统状况的双盲研究中，分别接受了0.1毫克、0.25毫克和0.5毫克氢溴酸东莨菪碱、1毫克口服劳拉西泮和安慰剂治疗。仅在高剂量（0.5毫克）时观察到东莨菪碱有显著的认知和行为效应，而较低剂量和劳拉西泮与安慰剂相比无显著差异。东莨菪碱引起的认知缺陷出现在新学习、语义记忆提取、警觉性和持续性操作等方面。行为效应包括兴奋、烦躁不安和焦虑，但对抑郁情绪无显著影响。这些结果表明，轻度至中度认知障碍的老年抑郁症患者在对短期胆碱能阻断的反应上，似乎更类似于先前研究的老年对照组，而非阿尔茨海默病患者，并表明老年抑郁症中常见的认知和情绪变化可能涉及除毒蕈碱胆碱能机制紊乱之外的其他因素。
