Cookies on this website
We use cookies to ensure that we give you the best experience on our website. If you click 'Continue' we'll assume that you are happy to receive all cookies and you won't see this message again. Click 'Find out more' for information on how to change your cookie settings.

Depression is very common in adolescence and is associated with a high risk of recurrence and suicide. Adolescents with depression experience the same symptoms as adults, such as sadness and fatigue, but some key differences exist. Depressed youth often feel irritable rather than or in addition to feeling low.

Despite being a common disorder, the pharmacological treatments available to treat depression in adolescence are scarce. Fluoxetine (or Prozac) is the only antidepressant licensed for use in the UK, still, very little is known about how this medication works in the brain of young people. This lack of knowledge constrains the development of new drugs.

A new study from the Psychopharmacology and Emotional Research Lab (PERL), A single dose of fluoxetine reduces neural limbic responses to anger in depressed adolescents, recently published in Translational Psychiatry, showed the effects of a single dose of fluoxetine on neural responses to emotional faces in depressed adolescents. Recent work from the PERL suggests that fluoxetine reduces the processing of anger, consistent with its effect for the treatment of irritability in young people (Capitão et al, 2015, Psychological Medicine). Hence, it could be predicted that fluoxetine would reduce the neural processing of angry faces.

Twenty-nine adolescents with Major Depressive Disorder (MDD), who had been recently prescribed fluoxetine by their psychiatrist, were randomised to receive their initial dose of 10mg fluoxetine vs. placebo. In line with predictions, after the single dose of fluoxetine, participants displayed reduced neural activity to angry facial expressions in a limbic region of the brain (a cluster that includes both the amygdala and the hippocampus), relative to placebo. Simultaneously, activity in the dorsal anterior cingulate cortex (dACC), known to be involved in self-regulation, was found to be increased. These results indicate that antidepressants may reduce the salience and/or increase the regulation of anger cues in young people with depression, right from the start of treatment.

The current study provides the first experimental evidence that, similarly to adults, antidepressants have immediate effects on emotional neural processing in young people within hours of administration and well before the therapeutic effects on mood emerge. The effect on anger is consistent with previous work and could therefore represent a key mechanism of action for subsequent improvement in symptoms of anger/irritability frequently seen in this population. Future studies should further explore the clinical implications of these effects, but it is hoped that these findings will assist the development of effective drug targets for adolescent depression, an area of research urgently needed.

Read the open-access paper in Translational Psychiatry.
www.nature.com/articles/s41398-018-0332-2

Similar stories

Collaborating with Youth is Key to Studying Mental Health Management

Research Highlights

The Global Mental Health Databank, a feasibility study, hopes to enable youth from the United Kingdom, South Africa, and India to work directly with mental health researchers to better understand how young people can manage their own mental health.

SSRI Treatment in Young People with Depression and Anxiety

Research Highlights

Results from an insight review commissioned by the Wellcome Trust, highlights what is currently known about the benefits and risks of using selective serotonin reuptake inhibitors (SSRIs) for the treatment of depression and anxiety in young people.

The brain understands relationships in the same way as it understands how to move in space

Research Highlights

Researchers led by a team at the Wellcome Centre for Integrative Neuroimaging at the University of Oxford have developed a new framework that binds together the way the brain forms maps of space to the way the brain understands relationships of any kind – general mental maps.

Researchers reveal surprising simplicity behind our ability to hear

Research Highlights

A computational modelling study from the King Group demonstrates that the way sounds are transformed from the ear to the brain’s auditory cortex may be simpler than expected. These findings not only highlight the value of computational modelling for determining the principles underlying neural processing, but could also be useful for improving treatments for patients with hearing loss.