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Heesbeen EJ, Bijlsma EY, Verdouw PM, van Lissa C, Hooijmans C, Groenink L. The effect of SSRIs on fear learning: a systematic review and meta-analysis. Psychopharmacology (Berl) 2023; 240:2335-2359. [PMID: 36847831 PMCID: PMC10593621 DOI: 10.1007/s00213-023-06333-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 01/31/2023] [Indexed: 03/01/2023]
Abstract
RATIONALE Selective serotonin reuptake inhibitors (SSRIs) are considered first-line medication for anxiety-like disorders such as panic disorder, generalized anxiety disorder, and post-traumatic stress disorder. Fear learning plays an important role in the development and treatment of these disorders. Yet, the effect of SSRIs on fear learning are not well known. OBJECTIVE We aimed to systematically review the effect of six clinically effective SSRIs on acquisition, expression, and extinction of cued and contextual conditioned fear. METHODS We searched the Medline and Embase databases, which yielded 128 articles that met the inclusion criteria and reported on 9 human and 275 animal experiments. RESULTS Meta-analysis showed that SSRIs significantly reduced contextual fear expression and facilitated extinction learning to cue. Bayesian-regularized meta-regression further suggested that chronic treatment exerts a stronger anxiolytic effect on cued fear expression than acute treatment. Type of SSRI, species, disease-induction model, and type of anxiety test used did not seem to moderate the effect of SSRIs. The number of studies was relatively small, the level of heterogeneity was high, and publication bias has likely occurred which may have resulted in an overestimation of the overall effect sizes. CONCLUSIONS This review suggests that the efficacy of SSRIs may be related to their effects on contextual fear expression and extinction to cue, rather than fear acquisition. However, these effects of SSRIs may be due to a more general inhibition of fear-related emotions. Therefore, additional meta-analyses on the effects of SSRIs on unconditioned fear responses may provide further insight into the actions of SSRIs.
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Affiliation(s)
- Elise J Heesbeen
- Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, Netherlands
| | - Elisabeth Y Bijlsma
- Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, Netherlands
| | - P Monika Verdouw
- Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, Netherlands
| | - Caspar van Lissa
- Department of Methodology, Tilburg University, Tilburg, Netherlands
| | - Carlijn Hooijmans
- Department of Anaesthesiology, Pain and Palliative Care, Radboud University Medical Center, Nijmegen, Netherlands
| | - Lucianne Groenink
- Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, Netherlands.
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Allen MT, Myers CE, Beck KD, Pang KCH, Servatius RJ. Inhibited Personality Temperaments Translated Through Enhanced Avoidance and Associative Learning Increase Vulnerability for PTSD. Front Psychol 2019; 10:496. [PMID: 30967806 PMCID: PMC6440249 DOI: 10.3389/fpsyg.2019.00496] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Accepted: 02/20/2019] [Indexed: 12/22/2022] Open
Abstract
Although many individuals who experience a trauma go on to develop post-traumatic stress disorder (PTSD), the rate of PTSD following trauma is only about 15-24%. There must be some pre-existing conditions that impart increased vulnerability to some individuals and not others. Diathesis models of PTSD theorize that pre-existing vulnerabilities interact with traumatic experiences to produce psychopathology. Recent work has indicated that personality factors such as behavioral inhibition (BI), harm avoidance (HA), and distressed (Type D) personality are vulnerability factors for the development of PTSD and anxiety disorders. These personality temperaments produce enhanced acquisition or maintenance of associations, especially avoidance, which is a criterion symptom of PTSD. In this review, we highlight the evidence for a relationship between these personality types and enhanced avoidance and associative learning, which may increase risk for the development of PTSD. First, we provide the evidence confirming a relationship among BI, HA, distressed (Type D) personality, and PTSD. Second, we present recent findings that BI is associated with enhanced avoidance learning in both humans and animal models. Third, we will review evidence that BI is also associated with enhanced eyeblink conditioning in both humans and animal models. Overall, data from both humans and animals suggest that these personality traits promote enhanced avoidance and associative learning, as well as slowing of extinction in some training protocols, which all support the learning diathesis model. These findings of enhanced learning in vulnerable individuals can be used to develop objective behavioral measures to pre-identify individuals who are more at risk for development of PTSD following traumatic events, allowing for early (possibly preventative) intervention, as well as suggesting possible therapies for PTSD targeted on remediating avoidance or associative learning. Future work should explore the neural substrates of enhanced avoidance and associative learning for behaviorally inhibited individuals in both the animal model and human participants.
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Affiliation(s)
- Michael Todd Allen
- School of Psychological Sciences, University of Northern Colorado, Greeley, CO, United States
- Rutgers Biomedical Health Sciences, Stress and Motivated Behavior Institute, Rutgers University, Newark, NJ, United States
- Central New York Research Corporation, Syracuse, NY, United States
| | - Catherine E. Myers
- Department of Veterans Affairs, VA New Jersey Health Care System, East Orange, NJ, United States
- Department of Pharmacology, Physiology and Neuroscience, Rutgers University-New Jersey Medical School, Newark, NJ, United States
| | - Kevin D. Beck
- Department of Veterans Affairs, VA New Jersey Health Care System, East Orange, NJ, United States
- Department of Pharmacology, Physiology and Neuroscience, Rutgers University-New Jersey Medical School, Newark, NJ, United States
| | - Kevin C. H. Pang
- Department of Veterans Affairs, VA New Jersey Health Care System, East Orange, NJ, United States
- Department of Pharmacology, Physiology and Neuroscience, Rutgers University-New Jersey Medical School, Newark, NJ, United States
| | - Richard J. Servatius
- Rutgers Biomedical Health Sciences, Stress and Motivated Behavior Institute, Rutgers University, Newark, NJ, United States
- Central New York Research Corporation, Syracuse, NY, United States
- Department of Veterans Affairs, Syracuse Veterans Affairs Medical Center, Syracuse, NY, United States
- Department of Psychiatry, State University of New York Upstate Medical University, Syracuse, NY, United States
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Menezes CEDS, McIntyre RS, Chaves Filho AJM, Vasconcelos SMM, de Sousa FCF, Quevedo J, Hyphantis TN, Carvalho AF, Macêdo D. The effect of paroxetine, venlafaxine and bupropion administration alone and combined on spatial and aversive memory performance in rats. Pharmacol Rep 2018; 70:1173-1179. [PMID: 30321807 DOI: 10.1016/j.pharep.2018.07.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2018] [Revised: 06/07/2018] [Accepted: 07/20/2018] [Indexed: 01/03/2023]
Abstract
BACKGROUND The use of antidepressants in combination is common practice following non-response to single antidepressant agents. Nevertheless, the scientific literature lacks preclinical studies regarding the combined administration of antidepressants across multiple behavioral measures including, but not limited to, cognition. Hence, we aimed to determine the effects of paroxetine (PAR), venlafaxine (VEN) and bupropion (BUP) alone or combined (PAR+BUP or VEN+BUP) on spatial and affective memory tasks to advance the knowledge about the combined use of antidepressants in cognition. METHODS Adult rats received daily injections (15 days) of PAR (20mg/kg, ip), VEN (20mg/kg, ip), BUP (20mg/kg, ip) alone or combined and were submitted to behavioral measures of spatial memory (radial-arm maze - RAM), aversive memory (passive avoidance - PA), open field (OF) and forced swimming (FST) tests. RESULTS In the RAM, VEN or VEN+BUP impaired learning, while short-term memory (STM) was impaired by PAR, BUP and their combination. VEN+BUP improved STM as compared to BUP. PAR impaired long-term memory (LTM). VEN or BUP alone impaired STM and long-term fear memory, whilst PAR+BUP or VEN+BUP did not induce significant alterations. CONCLUSIONS The effects of VEN, PAR or BUP alone and in combination on measures of memory are variable and vary as a function of the pharmacodynamics profile of each drug as well as the specific memory paradigm.
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Affiliation(s)
| | - Roger S McIntyre
- Department of Psychiatry, Department of Pharmacology and Toxicology, Mood Disorders Psychopharmacology Unit, University of Toronto, Toronto, ON, Canada
| | | | | | | | - João Quevedo
- Laboratory of Neurosciences, University of Southern Santa Catarina, Criciúma, SC, Brazil; Translational Psychiatry Program, Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA; Center of Excellence on Mood Disorders, Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA; Neuroscience Graduate Program, The University of Texas MD Anderson Cancer Center UTHealth Graduate School of Biomedical Sciences, Houston, TX, USA; Laboratory of Neurosciences, Graduate Program in Health Sciences, Health Sciences Unit, University of Southern Santa Catarina (UNESC), Criciúma, SC, Brazil
| | | | - André F Carvalho
- Department of Psychiatry, Department of Pharmacology and Toxicology, Mood Disorders Psychopharmacology Unit, University of Toronto, Toronto, ON, Canada; Centre for Addiction & Mental Health (CAMH), University of Toronto, Toronto, ON, Canada
| | - Danielle Macêdo
- Department of Physiology and Pharmacology, Federal University of Ceará, Fortaleza, CE, Brazil; National Institute for Translational Medicine (INCT-TM, CNPq), Ribeirão Preto, Brazil.
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Servatius RJ, Avcu P, Ko N, Jiao X, Beck KD, Minor TR, Pang KCH. Avoidance expression in rats as a function of signal-shock interval: strain and sex differences. Front Behav Neurosci 2015. [PMID: 26217200 PMCID: PMC4491620 DOI: 10.3389/fnbeh.2015.00168] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Inbred Wistar Kyoto (WKY) rats express inhibited temperament, increased sensitivity to stress, and exaggerated expressions of avoidance. A long-standing observation for lever press escape/avoidance learning in rats is the duration of the warning signal (WS) determines whether avoidance is expressed over escape. Outbred female Sprague-Dawley (SD) rats trained with a 10-s WS efficiently escaped, but failed to exhibit avoidance; avoidance was exhibited to a high degree with WSs longer than 20-s. We examined this longstanding WS duration function and extended it to male SD and male and female WKY rats. A cross-over design with two WS durations (10 or 60 s) was employed. Rats were trained (20 trials/session) in four phases: acquisition (10 sessions), extinction (10 sessions), re-acquisition (8 sessions) and re-extinction (8 sessions). Consistent with the literature, female and male SD rats failed to express avoidance to an appreciable degree with a 10-s WS. When these rats were switched to a 60-s WS, performance levels in the initial session of training resembled the peak performance of rats trained with a 60-s WS. Therefore, the avoidance relationship was acquired, but not expressed at 10-s WS. Further, poor avoidance at 10-s does not adversely affect expression at 60-s. Failure to express avoidance with a 10-s WS likely reflects contrasting reinforcement value of avoidance, not a reduction in the amount of time available to respond or competing responses. In contrast, WKY rats exhibited robust avoidance with a 10-s WS, which was most apparent in female WKY rats. Exaggerated expression of avoidances by WKY rats, especially female rats, further confirms this inbred strain as a model of anxiety vulnerability.
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Affiliation(s)
- Richard J Servatius
- Syracuse Veterans Affairs Medical Center, Stress and Motivated Behavior Institute Syracuse, NY, USA ; Department of Neuroscience, Stress and Motivated Behavior Institute, Rutgers Biomedical Health Sciences Newark, NJ, USA ; Rutgers Biomedical Health Sciences, Graduate School of Biomedical Sciences Newark, NJ, USA
| | - Pelin Avcu
- Syracuse Veterans Affairs Medical Center, Stress and Motivated Behavior Institute Syracuse, NY, USA ; Rutgers Biomedical Health Sciences, Graduate School of Biomedical Sciences Newark, NJ, USA
| | - Nora Ko
- Syracuse Veterans Affairs Medical Center, Stress and Motivated Behavior Institute Syracuse, NY, USA ; Rutgers Biomedical Health Sciences, Graduate School of Biomedical Sciences Newark, NJ, USA
| | - Xilu Jiao
- New Jersey Health Care System East Orange, NJ, USA
| | - Kevin D Beck
- Department of Neuroscience, Stress and Motivated Behavior Institute, Rutgers Biomedical Health Sciences Newark, NJ, USA ; Rutgers Biomedical Health Sciences, Graduate School of Biomedical Sciences Newark, NJ, USA ; New Jersey Health Care System East Orange, NJ, USA
| | - Thomas R Minor
- Psychology, University of California at Los Angeles Los Angeles, CA, USA
| | - Kevin C H Pang
- Department of Neuroscience, Stress and Motivated Behavior Institute, Rutgers Biomedical Health Sciences Newark, NJ, USA ; Rutgers Biomedical Health Sciences, Graduate School of Biomedical Sciences Newark, NJ, USA ; New Jersey Health Care System East Orange, NJ, USA
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