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David S. Janowsky, MD; M. Khaled EI-Yousef, MD; John M. Davis, MD; H. Joseph Sekerke, PhD

Arch Gen Psychiatry. 1973;28(4):542-547.

Abstract
Physostigmine, a reversible centrally active acetylcholinesterase inhibitor, was administered over a short period to eight patients with manic symptoms in a double-blind study. Patients were rated using standard manic rating scales.

All exhibited decreased manic symptoms within minutes of receiving physostigmine, and all developed an anergic syndrome. Some patients became depressed. Neither neostigmine methylsulfate (a noncentrally acting cholinesterase inhibitor) nor placebo significantly altered the behavior of the patients. These data are consistent with an adrenergic-cholinergic balance hypothesis of affective disorders.

Author Affiliations
Nashville, Tenn

From the departments of psychiatry and pharmacology, Vanderbilt University School of Medicine and the Tennessee Neuropsychiatric Institute, Nashville, Tenn.

Footnotes
Accepted for publication Nov 15, 1972.

Reprint requests to Department of Psychiatry, Vanderbilt University School of Medicine, Nashville, Tenn 37203 (Dr. Janowsky).

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