David Janowsky: Cholinergic muscarinic mechanisms in depression and mania 

Hector Warnes’ further comment

        I am grateful to Professor Janowsky for his open-mindedness and endless search for a simpler model of depression. I understand that 50% of emergencies at a Hospital in Bogotá, Colombia, are caused by Scopolamine (Burundanga) intoxication. Scopolamine is an anticholinergic and antimuscarinic agent that is found in the Belladonna alkaloids and also in Datura stramonium (Jimson Weed). It is sold in the USA in a transdermal patch called Transdermal Scop 1 mg., prescribed for seasickness and post-surgery. At higher doses it may induce a toxic psychosis with disorientation, loss of free will, amnesia and hallucinations. There has been lethality associated with its use and powerful drug-interactions are to be reckoned with.

        I would agree that it may set off a cascade of events in the CNS that could lead to having an antidepressant effect. I am surprised that in the last years even psilocybin (a psychedelic) has been found to ameliorate depression. I have not searched its antimuscarinic or anti-nicotinic properties but I recalled that there is a table which gives you a percentage of the atropinic effect of each drug.

        Again, I wish to thank Professor Janowsky for his openness to my comments.

May 14, 2020