A Single Dose of the Selective Serotonin Reuptake Inhibitor Citalopram Exacerbates Anxiety in Humans: A Fear-Potentiated Startle Study

• Published in: Neuropsychopharmacology (New York, N.Y.) Vol. 32; no. 1; pp. 225 - 231
• Main Authors: Grillon, Christian, Levenson, Jessica, Pine, Daniel S
• Format: Journal Article
• Language: English
• Published: New York, NY Nature Publishing 01.01.2007; Nature Publishing Group
• Subjects: Adolescent; Adult; Analysis of Variance; Anxiety; Anxiety - etiology; Anxiety - physiopathology; Biological and medical sciences; Citalopram - administration & dosage; Cross-Over Studies; Double-Blind Method; Electroshock - adverse effects; Fear - drug effects; Female; Humans; Male; Medical sciences; Neuropharmacology; Pharmacology. Drug treatments; Predictive Value of Tests; Psychoanaleptics: cns stimulant, antidepressant agent, nootropic agent, mood stabilizer..., (alzheimer disease); Psychology. Psychoanalysis. Psychiatry; Psychopharmacology; Reflex, Startle - drug effects; Serotonin Uptake Inhibitors - administration & dosage; Human; Serotonin; Psychotropic; Single dose; Emotion emotionality; Startle reflex; Reuptake inhibitor; predictability; Citalopram; Selective serotonin reuptake inhibitor; Fear; SSRI; Neurotransmitter; Antidepressant agent; Anxiety
• ISSN: 0893-133X; 1740-634X
• DOI: 10.1038/sj.npp.1301204

Serotonin reuptake inhibitors may increase symptoms of anxiety immediately following treatment initiation. The present study examined whether acute citalopram increased fear-potentiated startle to predictable and/or unpredictable shocks in healthy subjects. Eighteen healthy subjects each received two treatments, placebo and 20 mg citalopram in a crossover design. Participants were exposed to three conditions including one in which predictable aversive shocks were signaled by a cue, a second in which unpredictable shocks were anticipated, and a third in which no shocks were administered. Changes in aversive states were investigated using acoustic startle stimuli. Citalopram did not affect baseline startle. However, the phasic startle potentiation to the threat cue in the predictable condition was robustly increased by acute citalopram. The sustained startle potentiation in the unpredictable conditions was also increased by citalopram, but only when the drug was given during the first session. These results indicate that a single dose of citalopram is not anxiogenic in itself, but can exacerbate the expression of fear and anxiety.