Journal of Mental Science (1962) 108: 624-641. doi: 10.1192/bjp.108.456.624
© 1962 The Royal College of Psychiatrists
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Autonomic Function in Depression: A Modified Methacholine Test

J. T. Rose, M.D., D.P.M., Senior Registrar, St. James's Hospital Leeds

postal address: 66 North Park Avenue, Roundhay, Leeds 8

ABSTRACT

  1. The relevant literature on the Funkenstein test is reviewed, and conclusions are reached about the current status of this test.
  2. The rationale of giving the methacholine test under a condition of partial blockade of the autonomic ganglia is discussed, and the method is described of doing this modified form of the test, together with the standard test, on a group of depressed patients, as well as assessing them before and after electro-convulsive treatment.
  3. An examination is made of the relation between the test measures, the outcome after E.C.T., and the diagnostic groups. The results show no difference between the measures of the two tests considering the groups as a whole, no prognostic value of these measures, but a possible relation to the diagnostic groups in the females.
  4. The implications of these results are discussed, especially in relation to the theoretical basis of the Funkenstein (methacholine) test. It is argued that the only reliable component of this test—the drop in blood pressure—is chiefly related to peripheral end-organ sensitivity and is therefore unlikely to predict the response to E.C.T. Evidence is also given for doubting the validity of Gellhorn's theory that the methacholine test is an index of central sympathetic reactivity only.