摘要：

Central cholinergic factors may play a role in the tiology of affective disorders. Specifically, a given affective state may represent a balance between central cholinergic and adrenergic neurotransmitter activity in those areas of the brain which regulate affect, with depression being a disease of cholinergic dominance and mania being the converse. Support for this hypothesis comes from animal experiments demonstrating antagonistic cholinergic and adrenergic central behavioural effects. Furthermore, reserpine, a drug which causes depression, has central cholinomimetic properties. Conversely, tricyclic antidepressants have central anticholinergic properties. In man, physostigmine and other centrally acting cholinomimetic agents which increase central acetylcholine levels counteract mania and may cause depression in some individuals. Considering manic-depressive disorders and related phenomena from the viewpoint of cholinergic-adrenergic balance, or conceptualising behaviour as having both adrenergic and cholinergic components, provides a framework for understanding the affective disorders. Possibly, manic-depressive illness represents compensatory overreaction of certain parts of the central autonomic nervous system. A natural tendency toward hom1/2ostasis, associated with compensatory adrenergic activcation, could explain why most depressions are self-limiting. To balance hypothesis, more direct evidence is needed on the changes which occur in both systems during various affective states. Nevertheless, it seems that biological influences are involved in the tiology of affective disorders, and possibly they include cholinergic and adrenergic factors.

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