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Peters EM, Knorr U, Vinberg M, Kessing LV, Bowen R. A randomized placebo-controlled trial examining the effects of escitalopram on neuroticism and state anxiety in a nonclinical sample. Hum Psychopharmacol 2019; 34:e2711. [PMID: 31418950 DOI: 10.1002/hup.2711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Revised: 06/29/2019] [Accepted: 07/02/2019] [Indexed: 11/09/2022]
Abstract
OBJECTIVE This study reanalyzed data from a randomized placebo-controlled trial that failed to find an effect of the selective serotonin reuptake inhibitor escitalopram on neuroticism and state anxiety in a nonclinical sample. The purpose was to test for unique effects on two neuroticism factors, trait anxiety and mood instability, and to explore whether neuroticism moderated the effect of escitalopram on state anxiety. METHODS The sample included 80 adults who had a first-degree relative with major depression but without any psychiatric disorders themselves. Participants were randomized to escitalopram 10 mg/day or placebo for 4 weeks. Neuroticism was assessed with the Eysenck Personality Questionnaire (EPQ) and state anxiety with the Hamilton Anxiety Rating Scale (HAM-A). RESULTS The main effects on the neuroticism factors were not statistically significant, although there was a significant interaction such that the effect of escitalopram compared with placebo on HAM-A scores was statistically significant in participants with higher levels of EPQ trait anxiety, even after controlling for baseline HAM-A scores. A similar interaction with EPQ mood instability was nonsignificant. CONCLUSION A potential beneficial effect of escitalopram on neuroticism may be driven by reductions in anxiety.
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Affiliation(s)
- Evyn M Peters
- Department of Psychiatry, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Ulla Knorr
- Copenhagen Affective Disorder Research Center (CADIC), Psychiatric Center Copenhagen, Department O, section 6233, Rigshospitalet, Copenhagen, Denmark.,Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Maj Vinberg
- Copenhagen Affective Disorder Research Center (CADIC), Psychiatric Center Copenhagen, Department O, section 6233, Rigshospitalet, Copenhagen, Denmark.,Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Lars Vedel Kessing
- Copenhagen Affective Disorder Research Center (CADIC), Psychiatric Center Copenhagen, Department O, section 6233, Rigshospitalet, Copenhagen, Denmark.,Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Rudy Bowen
- Department of Psychiatry, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
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Madsen K, Torstensen E, Holst KK, Haahr ME, Knorr U, Frokjaer VG, Brandt-Larsen M, Iversen P, Fisher PM, Knudsen GM. Familial risk for major depression is associated with lower striatal 5-HT₄ receptor binding. Int J Neuropsychopharmacol 2014; 18:pyu034. [PMID: 25522384 PMCID: PMC4368872 DOI: 10.1093/ijnp/pyu034] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND The 5-HT4 receptor provides a novel potential target for antidepressant treatment. No studies exist to elucidate the 5-HT4 receptor's in vivo distribution in the depressed state or in populations that may display trait markers for major depression disorder (MDD). The aim of this study was to determine whether familial risk for MDD is associated with cerebral 5-HT4 receptor binding as measured with [(11)C]SB207145 brain PET imaging. Familial risk is the most potent risk factor of MDD. METHODS We studied 57 healthy individuals (mean age 36 yrs, range 20-86; 21 women), 26 of which had first-degree relatives treated for MDD. RESULTS We found that having a family history of MDD was associated with lower striatal 5-HT4 receptor binding (p = 0.038; in individuals below 40 years, p = 0.013). Further, we found evidence for a "risk-dose effect" on 5-HT4 receptor binding, since the number of first-degree relatives with a history of MDD binding correlated negatively with 5-HT4 receptor binding in both the striatum (p = 0.001) and limbic regions (p = 0.012). CONCLUSIONS Our data suggest that the 5-HT4 receptor is involved in the neurobiological mechanism underlying familial risk for depression, and that lower striatal 5-HT4 receptor binding is associated with increased risk for developing MDD. The finding is intriguing considering that the 5-HT4 receptor has been suggested to be an effective target for antidepressant treatment.
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Affiliation(s)
- Karine Madsen
- Neurobiology Research Unit, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark (Drs Madsen, Torstensen, Holst, Haahr, Frokjaer, Fisher, and Knudsen); Center for Integrated Molecular Brain Imaging, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark (Drs Madsen, Holst, Haahr, Frokjaer, Iversen, Fisher, and Knudsen); Department of Biostatistics, University of Copenhagen, Denmark (Dr Holst); Psychiatric Centre Copenhagen, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark (Dr Knorr); PET and Cyclotron Unit, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark (Dr Brandt-Larsen); Center for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark (Dr Iversen)
| | - Eva Torstensen
- Neurobiology Research Unit, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark (Drs Madsen, Torstensen, Holst, Haahr, Frokjaer, Fisher, and Knudsen); Center for Integrated Molecular Brain Imaging, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark (Drs Madsen, Holst, Haahr, Frokjaer, Iversen, Fisher, and Knudsen); Department of Biostatistics, University of Copenhagen, Denmark (Dr Holst); Psychiatric Centre Copenhagen, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark (Dr Knorr); PET and Cyclotron Unit, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark (Dr Brandt-Larsen); Center for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark (Dr Iversen)
| | - Klaus K Holst
- Neurobiology Research Unit, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark (Drs Madsen, Torstensen, Holst, Haahr, Frokjaer, Fisher, and Knudsen); Center for Integrated Molecular Brain Imaging, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark (Drs Madsen, Holst, Haahr, Frokjaer, Iversen, Fisher, and Knudsen); Department of Biostatistics, University of Copenhagen, Denmark (Dr Holst); Psychiatric Centre Copenhagen, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark (Dr Knorr); PET and Cyclotron Unit, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark (Dr Brandt-Larsen); Center for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark (Dr Iversen)
| | - Mette E Haahr
- Neurobiology Research Unit, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark (Drs Madsen, Torstensen, Holst, Haahr, Frokjaer, Fisher, and Knudsen); Center for Integrated Molecular Brain Imaging, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark (Drs Madsen, Holst, Haahr, Frokjaer, Iversen, Fisher, and Knudsen); Department of Biostatistics, University of Copenhagen, Denmark (Dr Holst); Psychiatric Centre Copenhagen, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark (Dr Knorr); PET and Cyclotron Unit, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark (Dr Brandt-Larsen); Center for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark (Dr Iversen)
| | - Ulla Knorr
- Neurobiology Research Unit, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark (Drs Madsen, Torstensen, Holst, Haahr, Frokjaer, Fisher, and Knudsen); Center for Integrated Molecular Brain Imaging, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark (Drs Madsen, Holst, Haahr, Frokjaer, Iversen, Fisher, and Knudsen); Department of Biostatistics, University of Copenhagen, Denmark (Dr Holst); Psychiatric Centre Copenhagen, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark (Dr Knorr); PET and Cyclotron Unit, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark (Dr Brandt-Larsen); Center for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark (Dr Iversen)
| | - Vibe G Frokjaer
- Neurobiology Research Unit, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark (Drs Madsen, Torstensen, Holst, Haahr, Frokjaer, Fisher, and Knudsen); Center for Integrated Molecular Brain Imaging, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark (Drs Madsen, Holst, Haahr, Frokjaer, Iversen, Fisher, and Knudsen); Department of Biostatistics, University of Copenhagen, Denmark (Dr Holst); Psychiatric Centre Copenhagen, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark (Dr Knorr); PET and Cyclotron Unit, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark (Dr Brandt-Larsen); Center for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark (Dr Iversen)
| | - Malene Brandt-Larsen
- Neurobiology Research Unit, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark (Drs Madsen, Torstensen, Holst, Haahr, Frokjaer, Fisher, and Knudsen); Center for Integrated Molecular Brain Imaging, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark (Drs Madsen, Holst, Haahr, Frokjaer, Iversen, Fisher, and Knudsen); Department of Biostatistics, University of Copenhagen, Denmark (Dr Holst); Psychiatric Centre Copenhagen, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark (Dr Knorr); PET and Cyclotron Unit, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark (Dr Brandt-Larsen); Center for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark (Dr Iversen)
| | - Pernille Iversen
- Neurobiology Research Unit, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark (Drs Madsen, Torstensen, Holst, Haahr, Frokjaer, Fisher, and Knudsen); Center for Integrated Molecular Brain Imaging, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark (Drs Madsen, Holst, Haahr, Frokjaer, Iversen, Fisher, and Knudsen); Department of Biostatistics, University of Copenhagen, Denmark (Dr Holst); Psychiatric Centre Copenhagen, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark (Dr Knorr); PET and Cyclotron Unit, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark (Dr Brandt-Larsen); Center for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark (Dr Iversen)
| | - Patrick M Fisher
- Neurobiology Research Unit, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark (Drs Madsen, Torstensen, Holst, Haahr, Frokjaer, Fisher, and Knudsen); Center for Integrated Molecular Brain Imaging, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark (Drs Madsen, Holst, Haahr, Frokjaer, Iversen, Fisher, and Knudsen); Department of Biostatistics, University of Copenhagen, Denmark (Dr Holst); Psychiatric Centre Copenhagen, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark (Dr Knorr); PET and Cyclotron Unit, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark (Dr Brandt-Larsen); Center for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark (Dr Iversen)
| | - Gitte M Knudsen
- Neurobiology Research Unit, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark (Drs Madsen, Torstensen, Holst, Haahr, Frokjaer, Fisher, and Knudsen); Center for Integrated Molecular Brain Imaging, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark (Drs Madsen, Holst, Haahr, Frokjaer, Iversen, Fisher, and Knudsen); Department of Biostatistics, University of Copenhagen, Denmark (Dr Holst); Psychiatric Centre Copenhagen, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark (Dr Knorr); PET and Cyclotron Unit, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark (Dr Brandt-Larsen); Center for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark (Dr Iversen).
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