Short-term SSRI treatment normalises amygdala hyperactivity in depressed patients

Antidepressant drugs such as selective serotonin re-uptake inhibitors (SSRIs) remediate negative biases in emotional processing in depressed patients in both behavioural and neural outcome measures. However, it is not clear if these effects occur before, or as a consequence of, changes in clinical s...

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Bibliographic Details
Published in:Psychological medicine 2012-12, Vol.42 (12), p.2609-2617
Main Authors: Godlewska, B. R., Norbury, R., Selvaraj, S., Cowen, P. J., Harmer, C. J.
Format: Article
Language:English
Subjects:
Adult
Adult and adolescent clinical studies
Amygdala
Amygdala - drug effects
Amygdala - physiopathology
Antidepressant drugs
Antidepressants
Attention - drug effects
Biological and medical sciences
Brain
Case-Control Studies
Citalopram - administration & dosage
Depression
Depressive Disorder, Major - drug therapy
Depressive Disorder, Major - physiopathology
Double-Blind Method
Drug Administration Schedule
Emotion recognition
Emotions
Emotions - drug effects
Facial Expression
Fear - drug effects
Fear - physiology
Female
Humans
Hyperactivity
Image Interpretation, Computer-Assisted
Information processing
Magnetic Resonance Imaging
Male
Medical sciences
Mental depression
Middle Aged
Mood disorders
Neurobiology
Neurons - drug effects
Neurons - physiology
Original
Original Articles
Pattern Recognition, Visual - drug effects
Pattern Recognition, Visual - physiology
Psychology. Psychoanalysis. Psychiatry
Psychopathology. Psychiatry
Reference Values
Serotonin reuptake inhibitors
Serotonin Uptake Inhibitors - administration & dosage
Short term
Young Adult
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Summary:Antidepressant drugs such as selective serotonin re-uptake inhibitors (SSRIs) remediate negative biases in emotional processing in depressed patients in both behavioural and neural outcome measures. However, it is not clear if these effects occur before, or as a consequence of, changes in clinical state. In the present study, we investigated the effects of short-term SSRI treatment in depressed patients on the neural response to fearful faces prior to clinical improvement in mood. Altogether, 42 unmedicated depressed patients received SSRI treatment (10 mg escitalopram daily) or placebo in a randomised, parallel-group design. The neural response to fearful and happy faces was measured on day 7 of treatment using functional magnetic resonance imaging. A group of healthy controls was imaged in the same way. Amygdala responses to fearful facial expressions were significantly greater in depressed patients compared to healthy controls. However, this response was normalised in patients receiving 7 days treatment with escitalopram. There was no significant difference in clinical depression ratings at 7 days between the escitalopram and placebo-treated patients. Our results suggest that short-term SSRI treatment in depressed patients remediates amygdala hyperactivity in response to negative emotional stimuli prior to clinical improvement in depressed mood. This supports the hypothesis that the clinical effects of antidepressant treatment may be mediated in part through early changes in emotional processing. Further studies will be needed to show if these early effects of antidepressant medication predict eventual clinical outcome.
ISSN:0033-2917
1469-8978
DOI:10.1017/S0033291712000591