Effect of a single dose of citalopram on amygdala response to emotional faces

Susannah E Murphy, Raymond Norbury, Ursula O'Sullivan, Philip J Cowen, Catherine J Harmer, Susannah E Murphy, Raymond Norbury, Ursula O'Sullivan, Philip J Cowen, Catherine J Harmer

Abstract

Background: Selective serotonin reuptake inhibitors (SSRIs) are typically thought to have a delay of several weeks in the onset of their clinical effects. However, recent reports suggest they may have a much earlier therapeutic onset. A reduction in amygdala responsivity has been implicated in the therapeutic action of SSRIs.

Aims: To investigate the effect of a single dose of an SSRI on the amygdala response to emotional faces.

Method: Twenty-six healthy volunteers were randomised to receive a single oral dose of citalopram (20 mg) or placebo. Effects on the processing of facial expressions were assessed 3 h later using functional magnetic resonance imaging.

Results: Volunteers treated with citalopram displayed a significantly reduced amygdala response to fearful facial expressions compared with placebo.

Conclusions: Such an immediate effect of an SSRI on amygdala responses to threat supports the idea that antidepressants have an earlier onset of therapeutically relevant effects than conventionally thought.

Figures

Fig. 1
Fig. 1
Increased right amygdala activation in the placebo group associated with the contrast between unmasked fear and unmasked neutral faces and plot of mean percentage blood oxygen level-dependent (BOLD) signal change in this right amygdala cluster after acute oral treatment with citalopram and placebo. Image is thresholded at Z = 2.3, P = 0.05, corrected. Bars show the mean; error bars show the standard error of the mean. Asterisks represent significant level of difference from placebo (**P<0.01).

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