Diminished neural processing of aversive and rewarding stimuli during selective serotonin reuptake inhibitor treatment
Background: Selective serotonin reuptake inhibitors (SSRIs) are popular medications for anxiety and depression, but their effectiveness, particularly in patients with prominent symptoms of loss of motivation and pleasure, has been questioned. There are few studies of the effect of SSRIs on neural re...
| Main Authors: | , , , |
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| Other Authors: | |
| Format: | Journal article |
| Language: | English |
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Elsevier
2010
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| _version_ | 1797096167114276864 |
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| author | McCabe, C Mishor, Z Cowen, P Harmer, C |
| author2 | Society of Biological Psychiatry |
| author_facet | Society of Biological Psychiatry McCabe, C Mishor, Z Cowen, P Harmer, C |
| author_sort | McCabe, C |
| collection | OXFORD |
| description | Background: Selective serotonin reuptake inhibitors (SSRIs) are popular medications for anxiety and depression, but their effectiveness, particularly in patients with prominent symptoms of loss of motivation and pleasure, has been questioned. There are few studies of the effect of SSRIs on neural reward mechanisms in humans. Methods: We studied 45 healthy participants who were randomly allocated to receive SSRI citalopram, the noradrenaline reuptake inhibitor reboxetine, or placebo for 7 days in a double-blind, parallel group design. We used functional magnetic resonance imaging to measure the neural response to rewarding (sight and/or flavor of chocolate) and aversive stimuli (sight of moldy strawberries and/or an unpleasant strawberry taste) on the final day of drug treatment. Results: Citalopram reduced activation to the chocolate stimuli in the ventral striatum and the ventral medial/orbitofrontal cortex. In contrast, reboxetine did not suppress ventral striatal activity and in fact increased neural responses within medial orbitofrontal cortex to reward. Citalopram also decreased neural responses to the aversive stimuli conditions in key "punishment" areas such as the lateral orbitofrontal cortex. Reboxetine produced a similar, although weaker effect. Conclusions: Our findings are the first to show that treatment with SSRIs can diminish the neural processing of both rewarding and aversive stimuli. The ability of SSRIs to decrease neural responses to reward might underlie the questioned efficacy of SSRIs in depressive conditions characterized by decreased motivation and anhedonia and could also account for the experience of emotional blunting described by some patients during SSRI treatment. |
| first_indexed | 2024-03-07T04:38:12Z |
| format | Journal article |
| id | oxford-uuid:d0b4c587-8014-440b-abd4-900fe1ecf799 |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-07T04:38:12Z |
| publishDate | 2010 |
| publisher | Elsevier |
| record_format | dspace |
| spelling | oxford-uuid:d0b4c587-8014-440b-abd4-900fe1ecf7992022-03-27T07:51:51ZDiminished neural processing of aversive and rewarding stimuli during selective serotonin reuptake inhibitor treatmentJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:d0b4c587-8014-440b-abd4-900fe1ecf799PsychiatryEnglishOxford University Research Archive - ValetElsevier2010McCabe, CMishor, ZCowen, PHarmer, CSociety of Biological PsychiatryBackground: Selective serotonin reuptake inhibitors (SSRIs) are popular medications for anxiety and depression, but their effectiveness, particularly in patients with prominent symptoms of loss of motivation and pleasure, has been questioned. There are few studies of the effect of SSRIs on neural reward mechanisms in humans. Methods: We studied 45 healthy participants who were randomly allocated to receive SSRI citalopram, the noradrenaline reuptake inhibitor reboxetine, or placebo for 7 days in a double-blind, parallel group design. We used functional magnetic resonance imaging to measure the neural response to rewarding (sight and/or flavor of chocolate) and aversive stimuli (sight of moldy strawberries and/or an unpleasant strawberry taste) on the final day of drug treatment. Results: Citalopram reduced activation to the chocolate stimuli in the ventral striatum and the ventral medial/orbitofrontal cortex. In contrast, reboxetine did not suppress ventral striatal activity and in fact increased neural responses within medial orbitofrontal cortex to reward. Citalopram also decreased neural responses to the aversive stimuli conditions in key "punishment" areas such as the lateral orbitofrontal cortex. Reboxetine produced a similar, although weaker effect. Conclusions: Our findings are the first to show that treatment with SSRIs can diminish the neural processing of both rewarding and aversive stimuli. The ability of SSRIs to decrease neural responses to reward might underlie the questioned efficacy of SSRIs in depressive conditions characterized by decreased motivation and anhedonia and could also account for the experience of emotional blunting described by some patients during SSRI treatment. |
| spellingShingle | Psychiatry McCabe, C Mishor, Z Cowen, P Harmer, C Diminished neural processing of aversive and rewarding stimuli during selective serotonin reuptake inhibitor treatment |
| title | Diminished neural processing of aversive and rewarding stimuli during selective serotonin reuptake inhibitor treatment |
| title_full | Diminished neural processing of aversive and rewarding stimuli during selective serotonin reuptake inhibitor treatment |
| title_fullStr | Diminished neural processing of aversive and rewarding stimuli during selective serotonin reuptake inhibitor treatment |
| title_full_unstemmed | Diminished neural processing of aversive and rewarding stimuli during selective serotonin reuptake inhibitor treatment |
| title_short | Diminished neural processing of aversive and rewarding stimuli during selective serotonin reuptake inhibitor treatment |
| title_sort | diminished neural processing of aversive and rewarding stimuli during selective serotonin reuptake inhibitor treatment |
| topic | Psychiatry |
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