INTRODUCTION: The serotonin specific reuptake inhibitor (SSRI) citalopram and the reversible mono-amine oxidase-A inhibitor (RIMA) moclobemide have both been used successfully for the treatment of social anxiety disorder (SAD). In this study we investigate the effects of these compounds on resting brain function using single photon emission computed tomography (SPECT). METHODS: Subjects meeting DSM-IV criteria for SAD underwent regional cerebral blood flow (rCBF) SPECT using Tc-HMPAO at baseline and after 8 weeks of treatment with either citalopram or moclobemide. Using statistical parametric mapping brain SPECT studies were analysed to determine the effects of treatment on rCBF, to compare the effects of citalopram and moclobemide, and to detect correlations between changes in rCBF and clinical response. RESULTS: Subjects received citalopram (n=17) or moclobemide (n=14) as therapy. Subjects in both treatment groups demonstrated a significant improvement of SAD symptoms as measured by the Liebowitz Social Anxiety Scale total score. All subjects demonstrated a decrease in rCBF in the insulae post therapy. Subjects receiving citalopram had decreased superior cingulate rCBF after therapy compared to those receiving moclobemide. CONCLUSION: Both SSRI's and RIMA's decreased rCBF in the insulae during treatment of SAD; an effect that may be consistent with the role of these regions in processing internal somatic cues evoked by emotional stimuli. Citalopram had a greater effect on superior cingulate perfusion, an effect that is consistent with evidence of high levels of 5-HT transporters in this region.
INTRODUCTION: The serotonin specific reuptake inhibitor (SSRI) citalopram and the reversible mono-amine oxidase-A inhibitor (RIMA) moclobemide have both been used successfully for the treatment of social anxiety disorder (SAD). In this study we investigate the effects of these compounds on resting brain function using single photon emission computed tomography (SPECT). METHODS: Subjects meeting DSM-IV criteria for SAD underwent regional cerebral blood flow (rCBF) SPECT using Tc-HMPAO at baseline and after 8 weeks of treatment with either citalopram or moclobemide. Using statistical parametric mapping brain SPECT studies were analysed to determine the effects of treatment on rCBF, to compare the effects of citalopram and moclobemide, and to detect correlations between changes in rCBF and clinical response. RESULTS: Subjects received citalopram (n=17) or moclobemide (n=14) as therapy. Subjects in both treatment groups demonstrated a significant improvement of SAD symptoms as measured by the Liebowitz Social Anxiety Scale total score. All subjects demonstrated a decrease in rCBF in the insulae post therapy. Subjects receiving citalopram had decreased superior cingulate rCBF after therapy compared to those receiving moclobemide. CONCLUSION: Both SSRI's and RIMA's decreased rCBF in the insulae during treatment of SAD; an effect that may be consistent with the role of these regions in processing internal somatic cues evoked by emotional stimuli. Citalopram had a greater effect on superior cingulate perfusion, an effect that is consistent with evidence of high levels of 5-HT transporters in this region.
Authors: Jeffrey P Lorberbaum; Samet Kose; Michael R Johnson; George W Arana; Lindsay K Sullivan; Mark B Hamner; James C Ballenger; R Bruce Lydiard; Peter S Brodrick; Daryl E Bohning; Mark S George Journal: Neuroreport Date: 2004-12-22 Impact factor: 1.837
Authors: Maartje M L de Win; Jan B A Habraken; Liesbeth Reneman; Wim van den Brink; Gerard J den Heeten; Jan Booij Journal: Neuropsychopharmacology Date: 2005-05 Impact factor: 7.853
Authors: P Roy-Byrne; J Fleishaker; C Arnett; M Dubach; J Stewart; A Radant; R Veith; M Graham Journal: Neuropsychopharmacology Date: 1993-02 Impact factor: 7.853
Authors: Paul D Carey; James Warwick; Dana J H Niehaus; Geoffrey van der Linden; Barend B van Heerden; Brian H Harvey; Soraya Seedat; Dan J Stein Journal: BMC Psychiatry Date: 2004-10-14 Impact factor: 3.630
Authors: Alex Doruyter; Patrick Dupont; Lian Taljaard; Dan J Stein; Christine Lochner; James M Warwick Journal: Metab Brain Dis Date: 2017-11-03 Impact factor: 3.584