Cholinergic neurotransmission seems not to be involved in depression but possibly in personality

J Psychiatry Neurosci. 1995 Jan;20(1):39-48.


Concordant with the adrenergic-cholinergic imbalance hypothesis of affective psychosis, there is a cholinergic supersensitivity in depression. Thus, the anticholinergic properties of some antidepressants might contribute to their efficacy. However, in the present double-blind studies (n = 20) with mianserin and viloxazine, respectively, which lack anticholinergic properties, adjunctive treatment with the anticholinergic biperiden versus placebo did not enhance the antidepressive efficacy. Therefore, we hypothesized that cholinergic supersensitivity might be linked to some possibly predisposing dimension of personality. Indeed, in healthy male volunteers (n = 11) the behavioral and cardiovascular sensitivity to physostigmine correlated significantly with "irritability" and "emotional lability" as well as with habitually passive strategies in stress coping. The rise in plasma cortisol and norepinephrine correlated with "retardation"; that of epinephrine with active coping. Thus, the cholinergic supersensitivity in affective psychoses might be linked to a personality dimension like stress sensitivity rather than to the diagnostic category itself.

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Acetylcholine / physiology
  • Adolescent
  • Adult
  • Aged
  • Arousal / drug effects
  • Arousal / physiology
  • Biperiden / administration & dosage
  • Cholinergic Fibers / drug effects
  • Cholinergic Fibers / physiology*
  • Depressive Disorder / drug therapy
  • Depressive Disorder / physiopathology*
  • Depressive Disorder / psychology
  • Dose-Response Relationship, Drug
  • Double-Blind Method
  • Drug Administration Schedule
  • Drug Therapy, Combination
  • Female
  • Humans
  • Male
  • Mianserin / administration & dosage
  • Middle Aged
  • Personality / drug effects
  • Personality / physiology*
  • Physostigmine / administration & dosage
  • Synaptic Transmission / drug effects
  • Synaptic Transmission / physiology*
  • Viloxazine / administration & dosage


  • Biperiden
  • Mianserin
  • Viloxazine
  • Physostigmine
  • Acetylcholine