A single dose of mirtazapine attenuates neural responses to self-referential processing

Emma Komulainen, Roope Heikkilä, Katarina Meskanen, Tuukka T. Raij, Lauri Nummenmaa, Jari Lahti, Pekka Jylhä, Tarja Melartin, Catherine J. Harmer, Erkki Isometsä, Jesper Ekelund*

*Corresponding author for this work

Research output: Contribution to journalArticleScientificpeer-review

10 Citations (Scopus)

Abstract

Increased self-focus is a core factor in the psychopathology of depression. Cortical midline structures (CMS) are implicated in the neurobiology of self, depression and antidepressant treatment response. Mirtazapine, an antidepressant that increases serotonin and norepinephrine release, enhances processing of positive and attenuates processing of negative emotional information in healthy volunteers after a single dose. These early changes, which are opposite to the negative information bias in depression, may be important for the therapeutic effect of mirtazapine. It nevertheless remains unresolved whether/how mirtazapine specifically influences processing of self-referential emotional information. Half of the healthy volunteers (n=15/30) received a single dose of mirtazapine, in an open-label design, two hours before functional magnetic resonance imaging (fMRI), and the other half was scanned as a control group without medication. During fMRI the participants categorized positive and negative self-referential adjectives. Mirtazapine attenuated responses to self-referential processing in the medial prefrontal cortex and the anterior cingulate cortex. Mirtazapine further decreased responses to positive self-referential processing in the posterior cingulate cortex and parietal cortex. These decreased responses of the CMS suggest that mirtazapine may rapidly improve the ability of the CMS to down-regulate self-referential processing. In depressed patients, this could lead to decreased self-focus and rumination, contributing to the antidepressant effect.

Original languageEnglish
Pages (from-to)23-32
Number of pages10
JournalJOURNAL OF PSYCHOPHARMACOLOGY
Volume30
Issue number1
DOIs
Publication statusPublished - Jan 2016
MoE publication typeA1 Journal article-refereed

Keywords

  • Antidepressant
  • mirtazapine
  • fMRI
  • emotions
  • self-referential processing
  • MAJOR DEPRESSIVE DISORDER
  • MEDIAL PREFRONTAL CORTEX
  • FUNCTIONAL MAGNETIC-RESONANCE
  • DEFAULT-MODE NETWORK
  • HEALTHY-VOLUNTEERS
  • NEURONAL RESPONSES
  • SELECTIVE SEROTONIN
  • AMYGDALA REACTIVITY
  • EMOTIONAL FACES
  • ANXIETY

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