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The Effect of SSRIs on Threat of Shock Potentiated Neural Circuitry

Not Applicable
Completed
Conditions
Anxiety
Interventions
Drug: Placebo
Registration Number
NCT07074652
Lead Sponsor
UCLH/UCL Joint Research Office
Brief Summary

This study aims to increase the knowledge about psychological processes which may contribute to mental health problems such as depression and anxiety. This study aims to investigate if administering Escitalopram, an antidepressant which increases serotonin levels in parts of the brain, affects how the brain processes emotional information. It is hoped that measuring these changes will increase the understanding of processes involved in mental health problems.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
145
Inclusion Criteria

Not provided

Exclusion Criteria

Not provided

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Healthy Control - EscitalopramEscitalopramParticipants took 10mg escitalopram for 2-3 weeks, once daily. Escitalopram was administered in the form of a tablet, manufactured and donated for research by Lundbeck (tablet core: microcrystalline cellulose, colloidal anhydrous silica, croscarmellose sodium, talc, magnesium stearate; tablet coating: hypromellose 6cP, titanium dioxide (E171), macrogol 6000). Exact length of administration was dependent on participants' availability to attend their second scan.
Healthy Control - PlaceboPlaceboParticipants took a placebo tablet for 2-3 weeks, once daily. Placebo was administered in the form of a tablet, manufactured and donated for research by Lundbeck and matching the escitalopram tablet given to the other study groups in colour and size. Exact length of administration was dependent on participants' availability to attend their second scan.
Anxious Individuals - EscitalopramEscitalopramParticipants took 10mg escitalopram for 2-3 weeks, once daily. Escitalopram was administered in the form of a tablet, manufactured and donated for research by Lundbeck (tablet core: microcrystalline cellulose, colloidal anhydrous silica, croscarmellose sodium, talc, magnesium stearate; tablet coating: hypromellose 6cP, titanium dioxide (E171), macrogol 6000). Exact length of administration was dependent on participants' availability to attend their second scan.
Anxious Individuals - PlaceboPlaceboParticipants took a placebo tablet for 2-3 weeks, once daily. Placebo was administered in the form of a tablet, manufactured and donated for research by Lundbeck and matching the escitalopram tablet given to the other study groups in colour and size. Exact length of administration was dependent on participants' availability to attend their second scan.
Primary Outcome Measures
NameTimeMethod
'Aversive amplification circuit' connectivityBaseline and 2-3 weeks after baseline

The engagement of the neural circuit of the amygdala, cingulate cortex and prefrontal cortex will be measured via an fMRI analysis technique called a psychophysiological interactions (PPI) analysis. PPI analysis concerns behaviour-specific increases in the relationship across regional brain activity - this means that it can allow one to assess whether two regions (a priori selected ROIs) show increased connectivity during a specific context or behaviour, suggesting a behaviour-specific increase in transfer of information. The output of this analysis will take form of a continuous beta weight - an index of connectivity across two brain regions (amygdala and medial prefrontal cortex), which represents the primary outcome of the study.

Secondary Outcome Measures
NameTimeMethod
Cognitive task performance: Loss/risk aversion taskBaseline and 2-3 weeks after baseline

Measures how averse participants are to risk and loss in a mock gambling context

Cognitive task performance: Go/no-go taskBaseline and 2-3 weeks after baseline

Measures approach/avoidance behaviours under threat of shock or safe conditions

Cognitive task performance: Facial emotional processing taskBaseline and 2-3 weeks after baseline

Measures brain responses to positive, negative and neutral emotions

Cognitive task performance: Visual affective bias taskBaseline and 2-3 weeks after baseline

Measures biases in patients' cognition towards or away from rewarding stimuli

Clinical symptom measure: Generalised Anxiety Disorder Scale (GAD-7)Baseline and 2-3 weeks after baseline

Measures symptoms of generalised anxiety, scored between 0-21 with higher scores indicating more severe symptoms

Cognitive task performance: Emotional face recognition taskBaseline and 2-3 weeks after baseline

Measures brain responses during two distinct memory processes - the encoding (learning) and retrieval (remembering) of information

Clinical symptom measures: Beck's Depression Inventory (BDI)Baseline and 2-3 weeks after baseline

Measures depressive symptoms, scored between 0-63 with higher scores indicating more severe symptoms

Clinical symptom measures: Catastrophizing questionnaireBaseline and 2-3 weeks after baseline

Measures catastrophising, scored between 24-120 with higher scores indicating more severe symptoms

Clinical symptom measures: Daily Stress Inventory (DSI)Baseline and 2-3 weeks after baseline

Measures frequency and impact of daily stresses. Frequency scored between 0-58 and impact scored between 0-6, with higher scores indicating more severe stress

Clinical symptom measures: Behavioural Inhibition/Behavioural Activation Scales (BIS/BAS)Baseline and 2-3 weeks after baseline

Measures drive, fun-seeking, reward responsiveness and behavioural inhibition. Behavioural inhibition scored between 7-28, drive between 4-16, fun seeking between 4-16, and reward between 5-20, with higher scores indicating higher levels of those behaviours

Clinical symptom measures: Eysenck Impulsiveness ScaleBaseline and 2-3 weeks after baseline

Measures impulsiveness, venturesomeness and empathy. Impulsivity scored between 0-19, venturesomeness between 0-16, empathy between 0-18, with higher scores indicating higher levels of those traits

Regional activations during neuroimaging task: Facial emotional processing taskBaseline and 2-3 weeks after baseline

Measures brain responses to positive, negative and neutral emotions

Regional activations during neuroimaging task: Emotional face recognition taskBaseline and 2-3 weeks after baseline

Measures brain responses during two distinct memory processes - the encoding (learning) and retrieval (remembering) of information

Regional activations during neuroimaging task: Visual affective bias taskBaseline and 2-3 weeks after baseline

Measures biases in patients' cognition towards or away from rewarding stimuli

Clinical symptom measure: State Trait Anxiety Inventory (STAI)Baseline and 2-3 weeks after baseline

Measures state and trait anxiety symptoms, scored between 20-80 with higher scores indicating more severe symptoms

Clinical symptom measures: Patient Health Questionnaire (PHQ-9)Baseline and 2-3 weeks after baseline

Measures depressive symptoms, scored between 0-27 with higher scores indicating more severe symptoms

Trial Locations

Locations (1)

University College London

🇬🇧

London, United Kingdom

University College London
🇬🇧London, United Kingdom

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