The influence of age-of-onset of antidepressant use on the acute CBF response to a citalopram challenge; a pharmacological MRI study

Psychiatry Res Neuroimaging. 2020 Sep 30:303:111126. doi: 10.1016/j.pscychresns.2020.111126. Epub 2020 Jun 13.

Abstract

Preclinical studies have demonstrated that antidepressant treatment in juvenile rodents affect the ontogeny of the serotonin system. However, whether early antidepressant use has similar effects on the development of the serotonin system in humans remains unknown. Therefore, we investigated whether effects of selective serotonin reuptake inhibitor (SSRI) treatment on the serotonin system are modulated by age. With pharmacological Magnetic Resonance Imaging the cerebral blood flow (CBF) response to an acute citalopram challenge was measured, as a proxy for serotonin function. Fifty-one females with major depressive disorder or anxiety disorder were stratified into three groups: 1) those treated with SSRIs <23 years of age, 2) those treated with SSRIs >23 years of age, and 3) those that were never treated with SSRIs. Additionally, a group of 14 healthy controls was included. CBF decreased after a citalopram challenge in the amygdala, hippocampus and orbitofrontal cortex across the whole sample. However, in contrast to preclinical studies, we did not find any age-dependent effect of SSRI exposure on the CBF response. In view of recent concerns on potential adverse effects of SSRIs administered to children, future studies are needed to replicate our negative findings in larger samples sizes and potentially in a prospective design.

Keywords: Adolescents; Antidepressants; Anxiety disorder; Citalopram; Development; Major depressive disorder; phMRI.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Age Factors
  • Antidepressive Agents, Second-Generation / administration & dosage
  • Anxiety Disorders / diagnostic imaging*
  • Anxiety Disorders / drug therapy
  • Cerebrovascular Circulation / drug effects*
  • Cerebrovascular Circulation / physiology
  • Child
  • Child, Preschool
  • Citalopram / administration & dosage*
  • Cross-Sectional Studies
  • Depressive Disorder, Major / diagnostic imaging*
  • Depressive Disorder, Major / drug therapy
  • Female
  • Humans
  • Infusions, Intravenous
  • Magnetic Resonance Imaging / methods*
  • Prospective Studies
  • Selective Serotonin Reuptake Inhibitors / administration & dosage*
  • Young Adult

Substances

  • Antidepressive Agents, Second-Generation
  • Serotonin Uptake Inhibitors
  • Citalopram