Scopolamine for My Bipolar Depression

I wrote a post back in December about seven mostly promising new drugs for antidepressant treatment.  Of the seven I am now looking towards scopolamine as a possible add-on to my current medication treatment.

For the record, each day I take Wellbutrin (450 mg), Cymbalta (120 mg), Lamictal (300 mg), Xanax (0.25 - 1 mg), NAC (2000 mg), multivitamin, fish oil, (300 mg omega-3 fatty acids), and aspirin (81 mg).

Background

Scopolamine has been shown in limited clinical testing to provide rapid, robust antidepressant effects for depression and bipolar depression.  The drug works much faster than SSRI type antidepressants, taking only hours instead of weeks to reach therapeutic levels.

However, it is not approved to treat depression or bipolar depression. Scopolamine is approved for use to control motion sickness and to reduce post operative nausea.  It is most often delivered transdermally (through the skin) using a special patch - a membrane-moderated transdermal drug delivery system.

I read through some online user reviews and ratings of scopolamine.  Not surprisingly, the effects from the patch varies from person to person.

The majority of people commenting say that the patch (scopolamine) works much better than OTC motion sickness medicine they have tried.  Some people wrote of side effects after removing the patch, mostly headache, nausea, dry throat/mouth, and blurred vision.  Most people say the side effects are worth the benefit of not getting motion sickness.

Scopolamine Findings

Based on what I have uncovered I find the following observations to be of interest:

• Intravenous scopolamine can be a rapidly acting, effective antidepressant.  Additional information is needed to asses the efficacy and tolerability of transdermal delivery.
• Scopolamine treats unipolar and bipolar depression.
• Scopolamine can be taken in several forms including orally, intravenously (IV), and transdermally (through the skin).
• Side effects concerns include memory impairment, dry mouth, nasea, drowsiness, blurred vision, and headache.
• Scopolamine works better for women than men.  That seems odd?
• Scopolamine for depression treatment still requires further study to determine therapeutic dosages, delivery mechanisms, side/withdrawal effects, and other relevant factors.  There needs to be more data with statistical relevance (e.g., larger sample sizes) analyzed for treatment efficacy and tolerability.   

The Scopolamine "Test"

So, after digesting several scopolamine studies and other web sources I decided to give it a go!

The scopolamine I received was through the skin (transdermal) by a patch.  This patch has the brand name Transderm Scop and requires a prescription in the U.S.  In Canada they are available from pharmacists without a physician's prescription.  Yay!

According to the package a Transderm Scop patch contains 1.5 mg of scopolamine.  The1.5 mg of scopolamine is programmed to deliver 0.5 mg per day over three days.  This is the approximate equivalent of a 72 hour continuous intravenous infusion at 5 micrograms per hour.  According to fellow blogger Garth Kroeker, a patch dose ". . . would roughly approximate the IV doses [4 micrograms per kilogram) used in several studies . . ."

I didn't have any patches handy but my friend had an extra patch and gave it to me.  It expired in 2001 so I'm hoping it still works.  This clearly is not a scientific study!

I applied the patch at 10 am.  After about 30 minutes I felt a little nausea.  This could be from an empty stomach with psych meds and coffee?

Wow! It's been an hour and I just realized pupil in my right eye is huge!  The left is normal.  I've been rubbing my right eye.  Maybe I got some scopolamine in my eye!  I hope this goes away.  My vision seems fine.

I looked on drugs.com for side effects related to vision.  There was a mention of unilateral dilation being reported suggesting "some ocular events may be due to inadvertent contamination of the eye when there is failure to wash the hands after drug application."

Well that makes sense.  I didn't wash my hands with soap and water after applying the patch.  Note to self: keep scopolamine out of eye and try to follow directions better.

Scopolamine: Final Analysis

Well, results are inconclusive.  The patch had no noticeable therapeutic effect for me.  Also, there was very little trouble (if any) with side effects or withdrawal effects.

I wore it for the directed 3 days.  I wore it an additional 4 days out of concern of withdrawal effects.

The big questions are whether the expired patch I used was effective and if I received a therapeutic dose.  I would guess the patch was ineffective and I didn't receive enough scopolamine.  Need to repeat test.

My next move is to obtain some patches that haven't expired and try this again.

By the way, my dilated pupil returned to normal by the third day.