Purinergic Signalling

, Volume 7, Issue 4, pp 447–452

Electroconvulsive therapy: a novel hypothesis for the involvement of purinergic signalling

  • Ahmed-Ramadan Sadek
  • Gillian E. Knight
  • Geoffrey Burnstock
Original Article

DOI: 10.1007/s11302-011-9242-y

Cite this article as:
Sadek, AR., Knight, G.E. & Burnstock, G. Purinergic Signalling (2011) 7: 447. doi:10.1007/s11302-011-9242-y


It is proposed that ATP is released from both neurons and glia during electroconvulsive therapy (ECT) and that this leads to reduction of depressive behaviour via complex stimulation of neurons and glia directly via P2X and P2Y receptors and also via P1 receptors after extracellular breakdown of ATP to adenosine. In particular, A1 adenosine receptors inhibit release of excitatory transmitters, and A2A and P2Y receptors may modulate the release of dopamine. Sequential ECT may lead to changes in purinoceptor expression in mesolimbic and mesocortical regions of the brain implicated in depression and other mood disorders. In particular, increased expression of P2X7 receptors on glial cells would lead to increased release of cytokines, chemokines and neurotrophins. In summary, we suggest that ATP release following ECT involves neurons, glial cells and neuron–glial interactions acting via both P2 and after breakdown to adenosine via P1 receptors. We suggest that ecto-nucleotidase inhibitors (increasing available amounts of ATP) and purinoceptor agonists may enhance the anti-depressive effect of ECT.


ATP Depression Electroconvulsive therapy Mood Puringeric signalling 

Copyright information

© Springer Science+Business Media B.V. 2011

Authors and Affiliations

  • Ahmed-Ramadan Sadek
    • 1
    • 2
  • Gillian E. Knight
    • 3
  • Geoffrey Burnstock
    • 3
  1. 1.Wessex Neurological CentreSouthampton University Hospitals NHS TrustSouthamptonUK
  2. 2.Division of Clinical Neurosciences, School of MedicineUniversity of SouthamptonSouthamptonUK
  3. 3.Autonomic Neuroscience CentreUniversity College Medical SchoolLondonUK