Elsevier LogoIt is said that traditional antidepressant treatments usually seem to need three to four weeks to become effective. Therefore, the finding of treatments with a swifter onset could be a chief objective of biological psychiatry. The first drug discovered to generate quick improvement in mood appears to be the NMDA glutamate receptor antagonist, ketamine.

Scientists from the National Institutes of Health account that another medication, scopolamine, also seems to generate replicable fast enhancement in mood. Scopolamine may momentarily obstruct the muscarinic cholinergic receptor, believed to be overactive in people with depression.

Drs. Wayne Drevets and Maura Furey enlisted outpatients with chief depressive disorder who were said to be indiscriminately allocated to be given placebo and then scopolamine treatment, or vice versa, in a double-blinded design so that neither the scientists nor the patients were aware as to which treatment they were given.

Dr. Furey commented, “Scopolamine was found to reduce symptoms of depression within three days of the first administration. In fact, participants reported that they experienced relief from their symptoms by the morning after the first administration of drug. Moreover, one-half of participants experienced full symptom remission by the end of the treatment period. Finally, participants remained well during a subsequent placebo period, indicating that the antidepressant effects persist for at least two weeks in the absence of further treatment.”

The effectiveness of scopolamine may be quite remarkable since the powerful obstruction of muscarinic receptors apparently was a property of tricyclic antidepressant medications, supposed to be the oldest kind of antidepressants. With these medications, the muscarinic receptor blockade was believed to be generally perceived as the cause of unnecessary side effects like constipation, sedation, and memory impairments.

Newer antidepressants like serotonin reuptake inhibitors or serotonin-norepinephrine reuptake inhibitors may be openly planned to evade obstructing muscarinic receptors. Yet, the present data may increase the likelihood that this strategy might have boosted security and tolerability of these medications at the cost of offering effectual and opportune respite for depression symptoms.

Dr. John Krystal, Editor of Biological Psychiatry, remarked, “These findings have potential to raise expectations for new antidepressant treatments. Three-to-six weeks is a long time to wait for depression symptoms to be alleviated. Depressed people describe their emotional state using terms like ‘agony’ and others compare their condition to ‘living in hell’. Further, depression is a life-threatening condition for some, preventing them from performing basic self-care functions or causing them to exhibit self-destructive behavior.”

Even though these discoveries may unlock the door to a theoretically different approach to the treatment of depression, one has to wait and watch to observe whether fast acting antidepressant effects may be feasible clinically. It could be envisaged that they might alleviate hospitalization in a few patients and improve the by and large efficiency of the treatment of depression. Nevertheless, this opportunity remains to be illustrated empirically in studies that may demonstrate that a rapid-acting antidepressant treatment may be easily transitioned to definitive long-term treatment for depression.

The findings appear in Biological Psychiatry, published by Elsevier.