ReviewEuropean journal of pharmacology2015
The catecholaminergic-cholinergic balance hypothesis of bipolar disorder revisited.
Review in European journal of pharmacology, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 42 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
42 citing papers in PubMed, 2 syntheses or guidelines pooled it, 101 citations in OpenAlex.
- Thyroid hormone levels in patients with bipolar disorder: a systematic review and meta-analysis.BMC endocrine disorders · 2024Pooled it
- Psychiatric Adverse Events of Acetylcholinesterase Inhibitors in Alzheimer's Disease and Parkinson's Dementia: Systematic Review and Meta-Analysis.Drugs & aging · 2023Pooled it
- Amphetamine increases activity but not exploration in humans and mice.Psychopharmacology · 2016Trial
- Assessment of the Therapeutic Potential of Hesperidin and Quercetin Nanoparticles on Oxidative Stress, Enzyme Activities, Trophic Factors, and Monoamines in an Animal Model of Depression.Neurochemical research · 2025Article
- Behavioral manifestations and underlying mechanisms of amphetamine in constructing animal models of mania: a comprehensive review.Frontiers in neuroscience · 2025Review
- Septohippocampal cholinergic system at the intersection of stress and cognition: Current trends and translational implications.The European journal of neuroscience · 2024Review
- Microbiota-gut-brain axis mechanisms in the complex network of bipolar disorders: potential clinical implications and translational opportunities.Molecular psychiatry · 2023Review
- Is SARS-CoV-2 a Risk Factor of Bipolar Disorder?-A Narrative Review.Journal of clinical medicine · 2022Review
- Microstructural imaging and transcriptomics of the basal forebrain in first-episode psychosis.Translational psychiatry · 2022Article
- Normalization of impaired emotion inhibition in bipolar disorder mediated by cholinergic neurotransmission in the cingulate cortex.Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology · 2022Article
- Inhibition of glycogen synthase kinase 3 by lithium, a mechanism in search of specificity.Frontiers in molecular neuroscience · 2022Review
- The Elusive "Switch Process" in Bipolar Disorder and Photoperiodism: A Hypothesis Centering on NADPH Oxidase-Generated Reactive Oxygen Species Within the Bed Nucleus of the Stria Terminalis.Frontiers in psychiatry · 2022Article
- Acetylcholinesterase Inhibitors in the Treatment of Neurodegenerative Diseases and the Role of Acetylcholinesterase in their Pathogenesis.International journal of molecular sciences · 2021Review
- Takotsubo Syndrome Associated with a New Onset Manic Episode: A case report.The Journal of international medical research · 2021Article
- The role of acetylcholine in negative encoding bias: Too much of a good thing?The European journal of neuroscience · 2021Review
- Chronic nicotine, but not suramin or resveratrol, partially remediates the mania-like profile of dopamine transporter knockdown mice.European neuropsychopharmacology : the journal of the European College of Neuropsychopharmacology · 2021Article
- Targeting Mitochondrial Dysfunction for Bipolar Disorder.Current topics in behavioral neurosciences · 2021Review
- Association of Cholinergic Muscarinic M4 Receptor Gene Polymorphism with Schizophrenia.The application of clinical genetics · 2020Article
- Fine Tuning Muscarinic Acetylcholine Receptor Signaling Through Allostery and Bias.Frontiers in pharmacology · 2020Review
- Integrative Transcriptomics Reveals Sexually Dimorphic Control of the Cholinergic/Neurokine Interface in Schizophrenia and Bipolar Disorder.Cell reports · 2019Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 2 institutions in 2 countries.
Funding
Abstract
Bipolar disorder is a unique illness characterized by fluctuations between mood states of depression and mania. Originally, an adrenergic-cholinergic balance hypothesis was postulated to underlie these different affective states. In this review, we update this hypothesis with recent findings from human and animal studies, suggesting that a catecholaminergic-cholinergic hypothesis may be more relevant. Evidence from neuroimaging studies, neuropharmacological interventions, and genetic associations support the notion that increased cholinergic functioning underlies depression, whereas increased activations of the catecholamines (dopamine and norepinephrine) underlie mania. Elevated functional acetylcholine during depression may affect both muscarinic and nicotinic acetylcholine receptors in a compensatory fashion. Increased functional dopamine and norepinephrine during mania on the other hand may affect receptor expression and functioning of dopamine reuptake transporters. Despite increasing evidence supporting this hypothesis, a relationship between these two neurotransmitter systems that could explain cycling between states of depression and mania is missing. Future studies should focus on the influence of environmental stimuli and genetic susceptibilities that may affect the catecholaminergic-cholinergic balance underlying cycling between the affective states. Overall, observations from recent studies add important data to this revised balance theory of bipolar disorder, renewing interest in this field of research.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.