The neurotransmitter acetylcholine acts on cholinergic receptors in the CTZ, vestibular system, and cerebellum. Apfel, in Pharmacology and Physiology for Anesthesia, 2013 Anticholinergic Drugs The preclinical data associated with scopolamine also are reviewed and convey a vision for narrowing in on the therapeutic muscarinic receptor subtype(s) that support the antidepressant effects to guide the development of next generation antimuscarinic drug targets for depression. This chapter reviews the clinical antidepressant findings with scopolamine, including discussion of differential response across patient subgroups, as well as a review of biomarkers that predict clinical outcome. Thus, we are faced with a unique opportunity to build on the clinical observation associated with scopolamine through reverse translation to identify of targets that retain the clinical efficacy while reducing the side effect profile. In psychiatry, clinically validated pathways are unusual and thus merit further research in an effort develop more effect medicines for patients with mood disorders. Scopolamine reportedly has downstream signaling effects thought to be linked to neuroplasticity within glutamatergic synapses and consequent antidepressant action. Scopolamine is a nonselective muscarinic antagonist that has shown relatively rapid antidepressant effects, although to date the results are from limited clinical studies. Furey, in Advances in Pharmacology, 2020 Abstract A clinical trial is currently underway to investigate the effects of scopolamine in combination with escitalopram for the treatment of MDD (NCT03131050). Oral administrations of scopolamine are particularly attractive, as they may be appropriate for the use in outpatient settings. More recently, oral scopolamine as an adjunctive treatment for moderate to severe MDD has been shown to be a safe and efficacious treatment. A replicated RCT of intravenous scopolamine has shown robust antidepressant action, as measured by significant reductions in MADRS and HARS scores relative to baseline. Furthermore, scopolamine has been shown to induce the mTOR pathway and increase BDNF levels. In animals, scopolamine may decrease NMDAR gene expression, and therefore, have similar downstream effects to NMDA modulators like ketamine, preventing glutamate neurotoxicity. Scopolamine is an antimuscarinic that may also have glutamatergic modulating effects. McIntyre, in Neurobiology of Depression, 2019 Antimuscarinic Agents (Scopolamine) Some patients may experience disorientation and confusion. Scopolamine may worsen narrow angle glaucoma, cause difficulty urinating and lead to dry, itchy eyes. The most common side effects are drowsiness, dry mouth, blurred vision and dilation of the pupils. Scopolamine is also used to treat certain stomach or intestinal problems, muscle spasms, and Parkinson-like conditions. Scopolamine is used to prevent nausea and vomiting caused by motion sickness or from anesthesia given during surgery. Scopolamine must be taken before the onset of motion sickness to be effective. Scopolamine also may work directly on the vomiting center. Scopolamine prevents communication between the nerves of the vestibule and the vomiting center in the brain by blocking the action of acetylcholine. When a person who is susceptible to motion sickness experiences motion, the vestibule sends a signal through nerves to the vomiting center in the brain, and vomiting occurs. The vestibular part of the ear is very important for balance. It is not clear how scopolamine prevents nausea and vomiting due to motion sickness. Scopolamine is absorbed into the body through the skin. Scopolamine may be administered transdermally using a special delivery system that gradually releases scopolamine onto the skin over a period of days. Scopolamine is an oral, intravenous, ophthalmic or topical drug with many uses including the prevention of motion sickness. Jacoby, in Reference Module in Biomedical Sciences, 2017 Scopolamine (hyoscine hydrobromide)
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |