Restricted sedation and absence of cognitive impairments after administration of intranasal scopolamine

Weerts, A.; Pattyn, Nathalie; Putcha, Lakshmi; Hoag, Stephen W.; Ombergen, Angelique Van; Hallgren, Emma; Heyning, Paul Van de; Wuyts, Floris L.

doi:10.1177/0269881115598414

Cited by 11 publications

(6 citation statements)

References 24 publications

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“…Scopolamine can also be absorbed mucosally, as demonstrated by sublingual delivery [79,80]. It has been delivered sublingually at 0.15 mg/ dose [79], intranasally at 0.4 mg [81,82], orally at 0.4 -1.0 mg/ dose [80,83], and transdermally (Transderm Scop®) at 1.5 mg/ dose over 3 days as antiemetic treatments or prophylactics. Oral delivery, unlike mucosal or transdermal delivery, involves firstpass hepatic metabolism of scopolamine, thus restricting its bioavailability.…”

Section: Muscarinic Receptor Antagonistsmentioning

confidence: 99%

Treating Anxiety with either Beta Blockers or Antiemetic Antimuscarinic Drugs: A Review

Dooley¹

2015

Ment Health Fam Med

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Beta adrenergic receptor antagonists and antiemetic muscarinic receptor antagonists are useful for mental health in primary care and family medicine settings, as they provide favorable risk/benefit profiles, and especially so relative to benzodiazepines. Beta blockers (e.g., propranolol) prescribed off-label have been known for decades to provide some, albeit limited, anxiolytic benefit for patients affected by social anxiety disorder (social phobia), including performance anxiety. Blockage of adrenaline's binding to cardiovascular beta adrenergic receptors inhibits tachycardia, reduces blood pressure, and thus diminishes palpitations in acute anxiety and panic. However, beta blockers are not effective against the psychic (CNS) symptoms, such as anxiousness, fear, and avoidance. Another approach involves antiemetic muscarinic receptor antagonists that are available by prescription (e.g., scopolamine) or over-the-counter (e.g., meclizine) for the treatment of non-cardiovascular symptoms that manifest in anxiety disorders. Antiemetic agents inhibit nausea, vomiting, sweating, and in some instances other psychic (CNS) symptoms. The symptoms affected by antimuscarinic agents represent the "inverse" of the symptoms of acute anxiety affected by beta blockers. Thus, anxiety disorders can be treated by alternative biochemical pathways, as well as by affecting alternative symptoms thereof. The results of human clinical studies are summarized for both classes of anxiolytic agents that display complementary pharmacologic approaches to a diverse array of symptoms.

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Section: Muscarinic Receptor Antagonistsmentioning

confidence: 99%

Treating Anxiety with either Beta Blockers or Antiemetic Antimuscarinic Drugs: A Review

Dooley¹

2015

Ment Health Fam Med

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“…These authors observed a reduction in the gain of the vestibulo-ocular reflex and a decrease in the total caloric response after scopolamine administration (0.4 mg intranasally). These results could be explained by the binding sites for scopolamine on the vestibular nucleus ( Jaju, Kirsten & Wang, 1970 ; Jaju & Wang, 1971 ; Matsuoka, Domino & Morimoto, 1975 ; Pyykko et al, 1984 ), potentially in the inner ear end organs (vestibular hair cells) and in the vestibular nerve fibers ( Li, Chun & Ju, 2007 ; Weerts et al, 2015a ). Moreover, some authors ( Kushiro et al, 2008 ; Uchino & Kushiro, 2011 ) have suggested that the vestibular projections that reach the lower part of the spinal cord (L3) mostly originate from the posterior semi-circular canal.…”

Section: Discussionmentioning

confidence: 99%

The influence of scopolamine on motor control and attentional processes

Bestaven

Kambrun

Guehl

et al. 2016

PeerJ

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Background: Motion sickness may be caused by a sensory conflict between the visual and the vestibular systems. Scopolamine, known to be the most effective therapy to control the vegetative symptoms of motion sickness, acts on the vestibular nucleus and potentially the vestibulospinal pathway, which may affect balance and motor tasks requiring both attentional process and motor balance. The aim of this study was to explore the effect of scopolamine on motor control and attentional processes.Methods: Seven subjects were evaluated on four different tasks before and after a subcutaneous injection of scopolamine (0.2 mg): a one-minute balance test, a subjective visual vertical test, a pointing task and a galvanic vestibular stimulation with EMG recordings.Results: The results showed that the reaction time and the movement duration were not modified after the injection of scopolamine. However, there was an increase in the center of pressure displacement during the balance test, a decrease in EMG muscle response after galvanic vestibular stimulation and an alteration in the perception of verticality.Discussion: These results confirm that low doses of scopolamine such as those prescribed to avoid motion sickness have no effect on attentional processes, but that it is essential to consider the responsiveness of each subject. However, scopolamine did affect postural control and the perception of verticality. In conclusion, the use of scopolamine to prevent motion sickness must be considered carefully because it could increase imbalances in situations when individuals are already at risk of falling (e.g., sailing, parabolic flight).

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“…These authors observed a reduction in the gain of the vestibuloocular reflex and a decrease in the total caloric response after scopolamine administration (0.4 mg intranasally). These results could be explained by the binding sites for scopolamine on the vestibular nucleus (Jaju et al 1970;Jaju & Wang 1971;Matsuoka et al 1975;Pyykko et al 1984), potentially in the inner ear end organs (vestibular hair cells) and in the vestibular nerve fibers (Li et al 2007;Weerts et al 2015a). Moreover, some authors (Kushiro et al 2008;Uchino & Kushiro 2011) have suggested that the vestibular projections that reach the lower part of the spinal cord (L3) mostly originate from the posterior semi-circular canal.…”

Section: Discussionmentioning

confidence: 99%

Peer Review #1 of "The influence of scopolamine on motor control and attentional processes (v0.1)"

2016

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Background. Motion sickness may be caused by a sensory conflict between the visual and the vestibular systems. Scopolamine, known to be the most effective therapy to control the vegetative symptoms of motion sickness, acts on the vestibular nucleus and potentially the vestibulospinal pathway, which may affect balance and motor tasks requiring both attentional process and motor balance. The aim of this study was to explore the effect of scopolamine on motor control and attentional processes. Methods. Seven subjects were evaluated on four different tasks before and after a subcutaneous injection of scopolamine (0.2 mg): a one-minute balance test, a subjective visual vertical test, a pointing task and a galvanic vestibular stimulation with EMG recordings. Results. The results showed that the reaction time and the movement duration were not modified after the injection of scopolamine. However, there was an increase in the center of pressure displacement during the balance test, a decrease in EMG muscle response after galvanic vestibular stimulation and an alteration in the perception of verticality. Discussion. These results confirm that low doses of scopolamine such as those prescribed to avoid motion sickness have no effect on attentional processes, but that it is essential to consider the responsiveness of each subject. However, scopolamine did affect postural control and the perception of verticality. In conclusion, the use of scopolamine to prevent motion sickness must be considered carefully because it could increase imbalances in situations when individuals are already at risk of falling (e.g., sailing, parabolic flight).

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Restricted sedation and absence of cognitive impairments after administration of intranasal scopolamine

Abstract: Results show that intranasal scopolamine did not impair cognitive performance. Intranasal scopolamine might be a good alternative to promethazine for the alleviation of space motion sickness, since the agent has minimal sedative effects and does not hamper cognitive performance.

Cited by 11 publications

References 24 publications

Treating Anxiety with either Beta Blockers or Antiemetic Antimuscarinic Drugs: A Review

Treating Anxiety with either Beta Blockers or Antiemetic Antimuscarinic Drugs: A Review

The influence of scopolamine on motor control and attentional processes

Peer Review #1 of "The influence of scopolamine on motor control and attentional processes (v0.1)"

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