Centrally acting cholinomimetic drugs cause anergia, behavioral inhibition and depression. Centrally acting cholinomimetic drugs have antimanic properties. Combinations of acetylcholine precursors and centrally active cholinomimetic agents may cause augmented muscarinic effects, as may a combination of an antiadrenergic and cholinomimetic drugs. Centrally active anticholinergic agents may exert antidepressant effects. Affective disorder patients may show hyperreactivity to cholinomimetic agents, a phenomena which may have diagnostic significance.
        
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Janowsky DS, Risch SC, Gillin JC (1983) Adrenergic-cholinergic balance and the treatment of affective disorders Prog Neuropsychopharmacol Biological Psychiatry7: 297-307