Fig. 1.

Schematic hypothesis of purinergic signalling in electroconvulsive therapy. During electroconvulsive therapy, ATP is released from astrocytes, neurons and vascular endothelial cells. The ATP acts upon P2X7, P2Y₁ receptors and also P1 receptors after the extracellular breakdown of ATP to ADO. Activation of P2X7 and ADO receptors on glial cells results in increased release of cytokines, chemokines and neurotrophins, which act upon neurons in regions involved in the control of mood and motivation. Stimulation of P2Y receptors may modulate the release of dopamine (DA), glutamate (Glut) and nitric oxide (NO) all implicated in control of mood