Abstract
Background
Acute administration of selective serotonin and noradrenaline re-uptake blockers to healthy volunteers affects the processing of emotional information but it is not known if similar effects occur with antidepressants acting through other pharmacological mechanisms. Mirtazapine is a clinically established antidepressant with complex actions involving blockade of noradrenaline α2-adrenoceptors as well as a number of 5-HT receptor subtypes. The aim of the present study was to test whether, like monoamine re-uptake inhibitors, mirtazapine would also produce positive biases in emotional processing.
Methods
We studied 30 healthy volunteers who received either a single dose of mirtazapine (15 mg) or placebo in a parallel group, double-blind study. Two hours following medication administration, participants completed a battery of tasks testing various aspects of emotional processing including facial expression recognition, emotion potentiated startle, and emotional categorization and memory.
Results
Compared to placebo, mirtazapine significantly impaired the recognition of fearful facial expressions and reduced eye-blink responses in the emotion potentiated startle task. Participants receiving mirtazapine were also significantly quicker to respond to emotional self-relevant information in the categorization task and showed a positive bias in memory recall compared to those receiving placebo.
Conclusions
Our findings indicate that mirtazapine reduces fear processing in healthy volunteers, an effect similar to that produced by repeated administration of selective serotonin re-uptake inhibitors. In addition, mirtazapine increased memory for likeable versus dislikeable self-relevant information suggesting an induction of positive bias in emotional memory. Such effects may be important for our understanding of the neuropsychological mechanisms of antidepressant action in both anxiety and depressive disorders.
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Disclosure/conflict of interest
This study was funded by the UK MRC. DA is currently supported by the UK MRC. PJC has received remuneration from serving as a member of advisory boards of Eli Lilly, Wyeth, Servier, Xytis and DSM. CJH serves on the advisory panel of P1vital and has received remuneration for consultancy from the following companies: Lundbeck, Servier and P1vital.
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Arnone, D., Horder, J., Cowen, P.J. et al. Early effects of mirtazapine on emotional processing. Psychopharmacology 203, 685–691 (2009). https://doi.org/10.1007/s00213-008-1410-6
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DOI: https://doi.org/10.1007/s00213-008-1410-6