title: Two weeks of pretreatment with escitalopram facilitates extinction learning in healthy individuals.
abstract: OBJECTIVE
  We aimed to examine whether pretreatment with escitalopram would be associated with reduced fear acquisition and enhanced extinction learning in a fear conditioning paradigm, compared with placebo.
  
  
  METHODS
  Healthy volunteers were randomized in double-blind fashion, to 14 days of escitalopram 10 mg/day (n = 18) or placebo (n = 20) prior to a classical fear conditioning paradigm.
  
  
  RESULTS
  Although escitalopram was associated with a smaller skin conductance (SC) orienting response during habituation, no medication effects on fear acquisition were found. Escitalopram was associated with faster extinction of SC responses, compared with placebo, as revealed by a significant drug × conditioned stimulus × trial interaction for early extinction (F(3, 30) = 3.26, p = 0.035) and late extinction (F(3, 30) = 3.27, p = 0.035) trials. After adjustment for age, orienting response, and acquisition, results from linear contrast remained significant for early extinction (F(1, 29) = 5.43, p = 0.027).
  
  
  CONCLUSIONS
  Escitalopram administered for 14 days prior to a fear conditioning paradigm did not influence acquisition of a conditioned fear response but did facilitate extinction learning. Impairments in extinction learning have been identified as a key component of posttraumatic stress disorder; our preliminary findings suggest that additional experimental and clinical studies assessing the efficacy of selective serotonin reuptake inhibitors for posttraumatic stress disorder prevention are warranted.
authors.affiliation: Center for Anxiety and Traumatic Stress Disorders, Massachusetts General Hospital, Boston, Massachusetts, USA; Harvard Medical School, Boston, Massachusetts, USA; Laboratoire du Stress Traumatique (EA4560), CHU de Toulouse & Université Toulouse 3, Toulouse, France.
authors.forename: Eric
authors.initials: E
authors.lastname: Bui
authors.forename: Scott P
authors.initials: SP
authors.lastname: Orr
authors.forename: Ryan J
authors.initials: RJ
authors.lastname: Jacoby
authors.forename: Aparna
authors.initials: A
authors.lastname: Keshaviah
authors.forename: Nicole J
authors.initials: NJ
authors.lastname: LeBlanc
authors.forename: Mohammed R
authors.initials: MR
authors.lastname: Milad
authors.forename: Mark H
authors.initials: MH
authors.lastname: Pollack
authors.forename: Naomi M
authors.initials: NM
authors.lastname: Simon
mesh_terms: D000328:Adult; D015283:Citalopram / Q000008:administration & dosage*; D003213:Conditioning, Psychological / Q000187:drug effects* / Q000502:physiology; D004311:Double-Blind Method; D005108:Extinction, Psychological / Q000187:drug effects* / Q000502:physiology; D005239:Fear / Q000187:drug effects* / Q000502:physiology / Q000523:psychology; D005260:Female; D006801:Humans; D007858:Learning / Q000187:drug effects* / Q000502:physiology; D008297:Male; D008875:Middle Aged; D017367:Selective Serotonin Reuptake Inhibitors / Q000008:administration & dosage*; D055815:Young Adult
chemical_list: D015283:Citalopram; D017367:Selective Serotonin Reuptake Inhibitors
keywords: SSRI; acute stress disorder; extinction learning; fear acquisition; posttraumatic stress disorder; prevention