title: Impact of acute administration of escitalopram on the processing of emotional and neutral images: a randomized crossover fMRI study of healthy women.
abstract: BACKGROUND
  Acute neural effects of antidepressant medication on emotion processing biases may provide the foundation on which clinical outcomes are based. Along with effects on positive and negative stimuli, acute effects on neutral stimuli may also relate to antidepressant efficacy, yet these effects are still to be investigated. The present study therefore examined the impact of a single dose of the selective serotonin reuptake inhibitor escitalopram (20 mg) on positive, negative and neutral stimuli using pharmaco-fMRI.
  
  
  METHODS
  Within a double-blind, randomized, placebo-controlled crossover design, healthy women completed 2 sessions of treatment administration and fMRI scanning separated by a 1-week washout period.
  
  
  RESULTS
  We enrolled 36 women in our study. When participants were administered escitalopram relative to placebo, left amygdala activity was increased and right inferior frontal gyrus (IFG) activity was decreased during presentation of positive pictures (potentiation of positive emotion processing). In contrast, escitalopram was associated with decreased left amygdala and increased right IFG activity during presentation of negative pictures (attenuation of negative emotion processing). In addition, escitalopram decreased right IFG activity during the processing of neutral stimuli, akin to the effects on positive stimuli (decrease in negative appraisal).
  
  
  CONCLUSIONS
  Although we used a women-only sample to reduce heterogeneity, our results may not generalize to men. Potential unblinding, which was related to the subjective occurrence of side effects, occurred in the study; however, manipulation check analyses demonstrated that results were not impacted.
  
  
  CONCLUSIONS
  These novel findings demonstrate that a single dose of the commonly prescribed escitalopram facilitates a positive information processing bias. These findings provide an important lead for better understanding effects of antidepressant medication.
authors.affiliation: Discipline of Psychiatry, Sydney Medical School, University of Sydney, Royal North Shore Hospital, Australia SCAN Research and Teaching Unit, School of Psychology, University of Sydney, Australia.
authors.forename: Tim
authors.initials: T
authors.lastname: Outhred
authors.affiliation: Discipline of Psychiatry, Sydney Medical School, University of Sydney, Royal North Shore Hospital, Australia CADE Clinic, Department of Psychiatry, Royal North Shore Hospital, Australia Advanced Research and Clinical Highfield Imaging (ARCHI), University of Sydney, Royal North Shore Hospital, Australia.
authors.forename: Pritha
authors.initials: P
authors.lastname: Das
authors.affiliation: School of Psychology, University of Tasmania, Hobart, Australia.
authors.forename: Kim L
authors.initials: KL
authors.lastname: Felmingham
authors.affiliation: School of Psychology, University of New South Wales, Kensington, Australia.
authors.forename: Richard A
authors.initials: RA
authors.lastname: Bryant
authors.affiliation: Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom School of Psychology and Psychiatry, Monash University, Australia.
authors.forename: Pradeep J
authors.initials: PJ
authors.lastname: Nathan
authors.affiliation: Discipline of Psychiatry, Sydney Medical School, University of Sydney, Royal North Shore Hospital, Australia CADE Clinic, Department of Psychiatry, Royal North Shore Hospital, Australia Advanced Research and Clinical Highfield Imaging (ARCHI), University of Sydney, Royal North Shore Hospital, Australia.
authors.forename: Gin S
authors.initials: GS
authors.lastname: Malhi
authors.affiliation: Discipline of Psychiatry, Sydney Medical School, University of Sydney, Royal North Shore Hospital, Australia SCAN Research and Teaching Unit, School of Psychology, University of Sydney, Australia CADE Clinic, Department of Psychiatry, Royal North Shore Hospital, Australia Advanced Research and Clinical Highfield Imaging (ARCHI), University of Sydney, Royal North Shore Hospital, Australia University Hospital, University of São Paulo, São Paulo SP, Brazil.
authors.forename: Andrew H
authors.initials: AH
authors.lastname: Kemp
mesh_terms: D000328:Adult; D001921:Brain / Q000187:drug effects* / Q000502:physiology*; D001931:Brain Mapping; D015283:Citalopram / Q000494:pharmacology*; D018592:Cross-Over Studies; D004311:Double-Blind Method; D004644:Emotions / Q000187:drug effects* / Q000502:physiology*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D010775:Photic Stimulation; D017367:Selective Serotonin Reuptake Inhibitors / Q000494:pharmacology*; D014796:Visual Perception / Q000187:drug effects / Q000502:physiology
chemical_list: D015283:Citalopram; D017367:Selective Serotonin Reuptake Inhibitors