title: Effects of a selective serotonin reuptake inhibitor escitalopram on the cutaneous silent period: a randomized controlled study in healthy volunteers.
abstract: The cutaneous silent period (CSP) involves a transient inhibition of the electromyographic (EMG) activity in the hand muscles induced by a painful electrical stimulation of the digital nerves. The neurotransmitters potentially involved in mediating the CSP have not been completely elucidated thus far. However, few studies suggest that the monoaminergic system may play a role in the CSP. We elicited CSPs in the first dorsal interosseous muscle of the right hand before and 3h after administration of a single oral dose of the selective serotonin reuptake inhibitor escitalopram (20mg) or placebo. The two experimental sessions (drug and placebo) were performed in a random order at ≥1-week intervals. All recordings were numbered anonymously and analysed offline in a blind manner by one investigator. A significant increase in the CSP duration was observed 3h after escitalopram administration (p=0.01), and no changes were observed in the reflex latency and subjective pain sensation (p>0.05). No significant changes were observed in the CSP duration in subjects who received the placebo (all, p>0.05). Our results indicate that escitalopram increases the central disposition of serotonin and increases the activity of the spinal inhibitory interneurons on the α-motoneurons of the hand muscles. Thus, our results indicate the involvement of the monoaminergic system in controlling the spinal pain mechanisms by supraspinal descending pathways originating from the brainstem neural structures.
authors.affiliation: "Sapienza" University of Rome, Department of Medico-Surgical Sciences and Biotechnologies, Neurology Section, Rome, Italy. Electronic address: overtango@libero.it.
authors.forename: Francesco
authors.initials: F
authors.lastname: Pujia
authors.affiliation: "Sapienza" University of Rome, Polo Pontino, Department of Medico-Surgical Sciences and Biotechnologies, Latina, Italy.
authors.forename: Mariano
authors.initials: M
authors.lastname: Serrao
authors.affiliation: "Sapienza" University of Rome, Department of Medico-Surgical Sciences and Biotechnologies, Neurology Section, Rome, Italy.
authors.forename: Marianna
authors.initials: M
authors.lastname: Brienza
authors.affiliation: "Sapienza" University of Rome, Department of Medico-Surgical Sciences and Biotechnologies, Neurology Section, Rome, Italy.
authors.forename: Elisa
authors.initials: E
authors.lastname: Vestrini
authors.affiliation: "Sapienza" University of Rome, Department of Medico-Surgical Sciences and Biotechnologies, Neurology Section, Rome, Italy.
authors.forename: Gabriele Oreste
authors.initials: GO
authors.lastname: Valente
authors.affiliation: G.B. Bietti Foundation-IRCCS, Department of Neurophysiology of Vision and Neurophthalmology, Rome, Italy.
authors.forename: Gianluca
authors.initials: G
authors.lastname: Coppola
authors.affiliation: "Sapienza" University of Rome, Polo Pontino, Department of Medico-Surgical Sciences and Biotechnologies, Latina, Italy; IRCCS-Neuromed, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Pierelli
mesh_terms: D000328:Adult; D015283:Citalopram / Q000494:pharmacology*; D004311:Double-Blind Method; D004558:Electric Stimulation; D005260:Female; D006801:Humans; D007537:Isometric Contraction / Q000187:drug effects*; D008297:Male; D018482:Muscle, Skeletal / Q000187:drug effects* / Q000294:innervation / Q000503:physiopathology; D010146:Pain / Q000503:physiopathology; D012018:Reflex / Q000187:drug effects; D017367:Selective Serotonin Reuptake Inhibitors / Q000494:pharmacology*; D012867:Skin / Q000294:innervation; D013127:Spinal Nerves / Q000187:drug effects / Q000503:physiopathology
chemical_list: D015283:Citalopram; D017367:Selective Serotonin Reuptake Inhibitors
keywords: Brainstem descending system; Cutaneous silent period; Escitalopram; Placebo; Selective serotonin reuptake inhibitor