0
Article |

Reciprocal Changes in Psychosis and Mood After Physostigmine in a Patient With Alzheimer's Disease

Susan E. Molchan, MD; Benedetto Vitiello, MD; Marcia Minichiello, MA; Trey Sunderland, MD
Arch Gen Psychiatry. 1991;48(12):1113-1114. doi:10.1001/archpsyc.1991.01810360077011
Text Size: A A A
Published online

To the Editor.—  The role of the cholinergic system in neuropsychiatric disease has been the topic of two recent articles in the Archives.1,2 The cognitive and behavioral effects of the cholinesterase inhibitor physostigmine salicylate in patients with Alzheimer's disease has been the subject of an ongoing study. We describe the fluctuation in one patient's psychotic and depressive symptoms that were consistent with the hypotheses that associate increased muscarinic activity with depressive and negative symptoms. The patient's psychotic symptoms were alleviated, although the depressive symptoms increased with physostigmine treatment. This agent presumably increases the functional activity of acetylcholine and causes a relative decrease in dopaminergic activity (as reflected by a decrease in cerebrospinal fluid homovanillic acid). This fluctuation of symptoms and biochemical profile suggests certain parallels to patients with schizophrenia, in whom increased muscarinic activity has been associated with depressive and negative symptoms, and increased mesocorticolimbic dopaminergic activity with psychosis.1

REFERENCES

Tandon R, Greden JF.  Cholinergic hyperactivity and negative schizophrenic symptoms: a model of cholinergic/dopaminergic interactions in schizophrenia . Arch Gen Psychiatry . 1989;;46:745-753.
Gillin JC, Sutton L, Ruiz C, Kelsoe J, Dupont RM, Darko D, Risch SC, Golshan S, Janowsky D.  The cholinergic rapid eye movement induction test with arecoline in depression . Arch Gen Psychiatry . 1991;;48:264-270.
Bunney WE, Hamburg DA.  Methods for reliable longitudinal observation of behavior . Arch Gen Psychiatry . 1963;; 9:280-294.
Terry RD, Davies P.  Dementia of the Alzheimer type . Annu Rev Neurosci . 1980;;3:77-95.

First Page Preview

First page PDF preview

Figures

Tables

Interactive Graphics

Video

Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

Tandon R, Greden JF.  Cholinergic hyperactivity and negative schizophrenic symptoms: a model of cholinergic/dopaminergic interactions in schizophrenia . Arch Gen Psychiatry . 1989;;46:745-753.
Gillin JC, Sutton L, Ruiz C, Kelsoe J, Dupont RM, Darko D, Risch SC, Golshan S, Janowsky D.  The cholinergic rapid eye movement induction test with arecoline in depression . Arch Gen Psychiatry . 1991;;48:264-270.
Bunney WE, Hamburg DA.  Methods for reliable longitudinal observation of behavior . Arch Gen Psychiatry . 1963;; 9:280-294.
Terry RD, Davies P.  Dementia of the Alzheimer type . Annu Rev Neurosci . 1980;;3:77-95.

Correspondence

CME Course for:


You need to register in order to view this quiz.


To understand the clinical management of acute heart failure syndromes.
Accreditation Information The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.
The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
To view and print your certificate and access a summary of your CME courses go to My CME.
NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s “Cited By” API will populate this tab (http://www.crossref.org/citedby.html).
Submit a Comment

Some tools below are only available to our subscribers or users with an online account.

Related Content

Customize your page view by dragging & repositioning the boxes below.