Intravenous Acetylcholine Therapy in Neurosis

Abstract

It is now several years since acetylcholine was first administered intramuscularly in the symptomatic treatment of anxiety, on the theory that anxiety was sympathicotonic in nature and could be counteracted by the vagotonic action of acetylcholine. Unfortunately decomposition of acetylcholine is so rapid that there is little time for this action to be effective, and the majority of investigators believe that it has no effect, or at least a momentary one, when given either subcutaneously or intramuscularly. Maxwell Jones (1936) used carbachol, a drug with a similar but more prolonged action than acetylcholine to treat six patients with anxiety neurosis. He was able to report relief from the psychic and somatic symptoms of anxiety in all cases but unfortunately, following withdrawal of the drug, they tended to relapse. An entirely different rationale led Tomasson (1936) to claim both alleviation and shortening of the duration of attacks of mania in manic depressive psychotics using a combined ephedrine and acetylcholine treatment.