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    Acute neural effects of fluoxetine on emotional regulation in depressed adolescents

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    Date
    2022-05
    Author
    Capitao, Liliana
    Chapman, Robert
    Wright, Lucy C
    Murphy, Susannah E
    James, Anthony
    Cowen, Philip J
    Harmer, Catherine J
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    Citation
    Capitão, L., Chapman, R., Filippini, N., Wright, L., Murphy, S., James, A., Cowen P., Harmer, C. (2022). Acute neural effects of fluoxetine on emotional regulation in depressed adolescents. Psychological Medicine, 1-12.
    Abstract
    Adolescent major depressive disorder (MDD) is associated with disrupted processing of emotional stimuli and difficulties in cognitive reappraisal. Little is known however about how current pharmacotherapies act to modulate the neural mechanisms underlying these key processes. The current study therefore investigated the neural effects of fluoxetine on emotional reactivity and cognitive reappraisal in adolescent depression. Methods Thirty-one adolescents with MDD were randomised to acute fluoxetine (10 mg) or placebo. Seventeen healthy adolescents were also recruited but did not receive any treatment for ethical reasons. During functional magnetic resonance imaging (fMRI), participants viewed aversive images and were asked to either experience naturally the emotional state elicited (‘Maintain’) or to reinterpret the content of the pictures to reduce negative affect (‘Reappraise’). Significant activations were identified using whole-brain analysis. Results No significant group differences were seen when comparing Reappraise and Maintain conditions. However, when compared to healthy controls, depressed adolescents on placebo showed reduced visual activation to aversive pictures irrespective of the condition. The depressed adolescent group on fluoxetine showed the opposite pattern, i.e. increased visuo-cerebellar activity in response to aversive pictures, when compared to depressed adolescents on placebo. Conclusions These data suggest that depression in adolescence may be associated with reduced visual processing of aversive imagery and that fluoxetine may act to reduce avoidance of such cues. This could reflect a key mechanism whereby depressed adolescents engage with negative cues previously avoided. Future research combining fMRI with eye-tracking is nonetheless needed to further clarify these effects.
    Description
    Open Access
    URI
    https://oxfordhealth-nhs.archive.knowledgearc.net/handle/123456789/1150
    Published online at:
    https://doi.org/10.1017/S0033291722001805
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    • Depressive Disorders [107]

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