title: Escitalopram prolonged fear induced by simulated public speaking and released hypothalamic-pituitary-adrenal axis activation.
abstract: Simulated public speaking (SPS) test is sensitive to drugs that interfere with serotonin-mediated neurotransmission and is supposed to recruit neural systems involved in panic disorder. The study was aimed at evaluating the effects of escitalopram, the most selective serotonin-selective reuptake inhibitor available, in SPS. Healthy males received, in a double-blind, randomized design, placebo (n = 12), 10 (n = 17) or 20 (n = 14) mg of escitalopram 2 hours before the test. Behavioural, autonomic and neuroendocrine measures were assessed. Both doses of escitalopram did not produce any effect before or during the speech but prolonged the fear induced by SPS. The test itself did not significantly change cortisol and prolactin levels but under the higher dose of escitalopram, cortisol and prolactin increased immediately after SPS. This fear-enhancing effect of escitalopram agrees with previously reported results with less selective serotonin reuptake inhibitors and the receptor antagonist ritanserin, indicating that serotonin inhibits the fear of speaking in public.
authors.affiliation: Department of Neurology, Psychiatry and Medical Psychology, Medical School of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil. cybelegleal@terra.com.br
authors.forename: C
authors.initials: C
authors.lastname: Garcia-Leal
authors.forename: C M
authors.initials: CM
authors.lastname: Del-Ben
authors.forename: F M
authors.initials: FM
authors.lastname: Leal
authors.forename: F G
authors.initials: FG
authors.lastname: Graeff
authors.forename: F S
authors.initials: FS
authors.lastname: Guimarães
mesh_terms: D000328:Adult; D000339:Affect / Q000187:drug effects / Q000502:physiology; D018687:Antidepressive Agents, Second-Generation / Q000008:administration & dosage / Q000009:adverse effects*; D015283:Citalopram / Q000008:administration & dosage / Q000009:adverse effects* / Q000097:blood; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D005239:Fear / Q000187:drug effects*; D005712:Galvanic Skin Response / Q000187:drug effects; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D007030:Hypothalamo-Hypophyseal System / Q000503:physiopathology*; D008297:Male; D010913:Pituitary-Adrenal System / Q000503:physiopathology*; D011388:Prolactin / Q000097:blood; D012701:Serotonin / Q000502:physiology; D017367:Selective Serotonin Reuptake Inhibitors / Q000008:administration & dosage / Q000009:adverse effects*; D013060:Speech / Q000502:physiology; D011795:Surveys and Questionnaires; D013997:Time Factors; D055815:Young Adult
chemical_list: D018687:Antidepressive Agents, Second-Generation; D015283:Citalopram; D006854:Hydrocortisone; D011388:Prolactin; D012701:Serotonin; D017367:Selective Serotonin Reuptake Inhibitors