title: Facilitation of emotion regulation with a single dose of escitalopram: A randomized fMRI study.
abstract: Acute antidepressant administration modulates neural activity consistent with decreases in negative emotion processing bias. However, studies are yet to examine whether treatment facilitates neural activity during reappraisal, an adaptive emotion regulation strategy associated with behavioral treatment response. Here we examine the impact of acute administration on reappraisal of negative stimuli using pharmaco-fMRI. Thirty-six healthy female participants completed two sessions of fMRI scanning, separated by a one-week washout period. A single dose of the selective serotonin reuptake inhibitor, escitalopram (20mg) was administered to participants using a double-blind, randomized, placebo-controlled crossover design. When participants were administered escitalopram (relative to a placebo) and asked to reappraise negative emotional stimuli, left amygdala activation was decreased and right inferior frontal gyrus (R IFG) activation was increased. Also observed was a greater negative left amygdala-R IFG functional connectivity when participants were administered escitalopram relative to placebo, and this change in connectivity was associated with reductions in subjective ratings of valence and arousal of negative stimuli. Further analysis revealed connectivity modulation across multiple frontal regions. Results suggest that the acute effect of a commonly prescribed antidepressant may include facilitating the regulation of negative emotional stimuli, providing new important leads for models of antidepressant action.
authors.affiliation: Discipline of Psychiatry, Sydney Medical School, University of Sydney, Royal North Shore Hospital, NSW 2065, Australia; SCAN Research and Teaching Unit, School of Psychology, University of Sydney, NSW 2006, 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, NSW 2065, Australia; CADE Clinic, Department of Psychiatry, Royal North Shore Hospital, NSW 2065, Australia; Advanced Research and Clinical Highfield Imaging (ARCHI), University of Sydney, Royal North Shore Hospital, NSW 2065, Australia.
authors.forename: Pritha
authors.initials: P
authors.lastname: Das
authors.affiliation: School of Psychology, University of Tasmania, Hobart, TAS 7001, Australia.
authors.forename: Kim L
authors.initials: KL
authors.lastname: Felmingham
authors.affiliation: School of Psychology, University of New South Wales, Kensington, NSW 2033, Australia.
authors.forename: Richard A
authors.initials: RA
authors.lastname: Bryant
authors.affiliation: Department of Psychiatry, University of Cambridge, Cambridge CB2 1QB, United Kingdom; School of Psychology and Psychiatry, Monash University, VIC 3800, 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, NSW 2065, Australia; CADE Clinic, Department of Psychiatry, Royal North Shore Hospital, NSW 2065, Australia; Advanced Research and Clinical Highfield Imaging (ARCHI), University of Sydney, Royal North Shore Hospital, NSW 2065, 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, NSW 2065, Australia; SCAN Research and Teaching Unit, School of Psychology, University of Sydney, NSW 2006, Australia; CADE Clinic, Department of Psychiatry, Royal North Shore Hospital, NSW 2065, Australia; Advanced Research and Clinical Highfield Imaging (ARCHI), University of Sydney, Royal North Shore Hospital, NSW 2065, Australia; Hospital Universitário, University of São Paulo, 05508-000 São Paulo, SP, Brazil. Electronic address: andrew.kemp@hu.usp.br.
authors.forename: Andrew H
authors.initials: AH
authors.lastname: Kemp
mesh_terms: D000293:Adolescent; D000328:Adult; D000679:Amygdala / Q000187:drug effects / Q000378:metabolism; D001143:Arousal / Q000187:drug effects / Q000502:physiology; D015283:Citalopram / Q000008:administration & dosage*; D018592:Cross-Over Studies; D004311:Double-Blind Method; D004644:Emotions / Q000187:drug effects* / Q000502:physiology; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D010775:Photic Stimulation / Q000379:methods; D017367:Selective Serotonin Reuptake Inhibitors / Q000008:administration & dosage*; D055815:Young Adult
chemical_list: D015283:Citalopram; D017367:Selective Serotonin Reuptake Inhibitors
keywords: Antidepressant; Emotion; Emotion regulation; Functional connectivity; Serotonin; fMRI