NO ANTIDEPRESSANT EFFECT OF BIPERIDEN COMPARED WITH PLACEBO IN DEPRESSION - A DOUBLE-BLIND 6-WEEK CLINICAL-TRIAL

Depression may result from an increased ratio of cholinergic to aminer gic central neurotransmission. The effect of centrally active antichol inergic agents on depressive ratings in depressed patients, however, h as not been well studied. In a previous open label 4-week clinical tri al, Kasper et al. (1981) reported that biperiden (Akineton) had antide pressant effects in depressed patients. We compared the effects of pla cebo and biperiden in a randomized, double-blind, parallel-design 6-we ek study. All patients received placebo for the first week and then re ceived either biperiden (less than or equal to 12 mg/day) or a periphe rally acting anticholinergic agent, glycopyrrolate (Robinul, 1 mg/day) for 4 weeks. All patients received placebo during week 6. Both groups significantly improved, but biperiden did not demonstrate any signifi cant benefit compared with glycopyrrolate. In a subgroup of patients r eceiving biperiden, the percentage of rapid eye movement sleep was sig nificantly decreased only in the first week of biperiden compared with the initial placebo week, suggesting that tolerance to the central ef fects of biperiden developed. Further studies would be needed to deter mine whether anticholinergic agents possess antidepressant properties.