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      Differential effects of serotonergic and noradrenergic antidepressants on brain activity during a cognitive control task and neurofunctional prediction of treatment outcome in patients with depression.

      Journal of psychiatry & neuroscience : JPN
      Adolescent, Adrenergic Uptake Inhibitors, therapeutic use, Adult, Analysis of Variance, Brain, drug effects, physiology, Citalopram, Cognition, Depressive Disorder, drug therapy, psychology, Electroencephalography, Evoked Potentials, Female, Humans, Image Processing, Computer-Assisted, Magnetic Resonance Imaging, Male, Middle Aged, Morpholines, Neuropsychological Tests, Oxygen, blood, Predictive Value of Tests, Psychiatric Status Rating Scales, Psychomotor Performance, Serotonin Uptake Inhibitors, Treatment Outcome, Young Adult

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          Abstract

          We investigated the differential effects of serotonergic and noradrenergic antidepressants on brain activation in patients with major depressive disorder during a Stroop task. We predicted that pretreatment hyperactivity in the rostral anterior cingulate cortex would predict better treatment outcomes. In total, 20 patients underwent naturalistic open-label clinical treatment with citalopram (n = 12) or reboxetine (n = 8). We performed functional magnetic resonance imaging at baseline and after 6 weeks of treatment. There were no significant group differences in clinical characteristics, treatment outcomes or baseline fMRI activations. The group by time interaction revealed significant voxels in the right amygdala-hippocampus complex (p < 0.05, family-wise error corrected by use of the bilateral amygdala and hippocampus mask image as a small volume), indicating a posttreatment blood oxygen level- dependent signal decrease in the citalopram group. Pretreatment hyperactivity in the rostral anterior cingulate cortex was not related to symptom improvement. Our study was a nonrandomized clinical trial. These results indicate that serotonergic and noradrenergic antidepressants have a differential effect on brain activity, especially in the amygdala and hippocampus.

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