The anticholinergic effects of the commonly used antidepressant

Abstract EN

This study included 120 patients with major depressive disorder, di¬vided into three groups: Group I: 60 patients received tricycle antidepressants (half of them Were put on amitripiyline and the other half on imipramine).

Group ii: 30 patients received tetra cyclic antidepressant maprotiline.

Group III: 30 patients received monoamine oxides inhibitor tranylcypro¬mine.

i To evaluate the anticholinergic effects, all patients were submitted to the following (before and after 6 days of using antidepressants): A) Estimation of volume of salivary secretion.

B) Estimation of concentration of salivary secretion: 1.

Concentration and output of amylase enzyme in salivary secre¬tion.

2.

Concentration and output of bicarbonate in salivary secretion.

C) Estimation of serum cholinesterase enzyme.

The results revealed the following: - The four drugs have decreasing effect on salivary Juice volume which could be used as indicator for the severity of anticholinergic activity.

Tricycles have more significant lowering of salivary volume than the other two.

- The anticholinergic effects of antidepressants are not only due to the relative affinity of these drugs for muscarine receptors (it interferes with the action of acetylcholine) as it was believed before, but it could be also attributed to the increase in serum cholinesterase enzyme which leads to more destruction of acetylcholine.

The increased concentrations of salivary amylase and bicarbonate could be ascribed to the increase in nor epinephrine which accompanies using these drugs.