Cerebral blood flow changes after treatment of social phobia with the neurokinin-1 antagonist GR205171, citalopram, or placebo.

@article{citeulike:1300151, abstract = {BACKGROUND: Evidence is accumulating that pharmacological blockade of the substance P preferring neurokinin-1 (NK1) receptor reduces anxiety. This study compared the effects of an NK1 receptor antagonist, citalopram, and placebo on brain activity and anxiety symptoms in social phobia. METHODS: Thirty-six patients diagnosed with social phobia were treated for 6 weeks with the NK1 antagonist GR205171 (5 mg), citalopram (40 mg), or matching placebo under randomized double-blind conditions. GR205171 was administered for 4 weeks preceded by 2 weeks of placebo. Before and after treatment, regional cerebral blood flow (rCBF) during a stressful public speaking task was assessed using oxygen-15 positron emission tomography. Response rate was determined by the Clinical Global Impression Improvement Scale. RESULTS: Patients improved to a larger extent with the NK1 antagonist (41.7\% responders) and citalopram (50\% responders), compared with placebo (8.3\% responders). Within- and between-group comparisons showed that symptom improvement was paralleled by a significantly reduced rCBF response to public speaking in the rhinal cortex, amygdala, and parahippocampal-hippocampal regions. The rCBF pattern was corroborated in follow-up analyses of responders and subjects showing large state anxiety reduction. CONCLUSIONS: Short-term administration of GR205171 and citalopram alleviated social anxiety. Neurokinin-1 antagonists may act like serotonin reuptake inhibitors by attenuating neural activity in a medial temporal lobe network.}, address = {Department of Psychology, Uppsala University, Uppsala, Sweden. tomas.furmark@psyk.uu.se}, author = {Furmark, T. and Appel, L. and Michelg\r{a}rd, A. and Wahlstedt, K. and Ahs, F. and Zancan, S. and Jacobsson, E. and Flyckt, K. and Grohp, M. and Bergstr\"{o}m, M. and Pich, E. M. and Nilsson, L. G. and Bani, M. and L\r{a}ngstr\"{o}m, B. and Fredrikson, M. }, citeulike-article-id = {1300151}, doi = {10.1016/j.biopsych.2005.03.029}, issn = {0006-3223}, journal = {Biol Psychiatry}, keywords = {neuroimaging, pet, pharmacotherapy, sad, treatment}, month = {July}, number = {2}, pages = {132--142}, posted-at = {2007-05-16 14:41:15}, priority = {2}, title = {Cerebral blood flow changes after treatment of social phobia with the neurokinin-1 antagonist GR205171, citalopram, or placebo.}, url = {http://dx.doi.org/10.1016/j.biopsych.2005.03.029}, volume = {58}, year = {2005} }

TY - JOUR ID - citeulike:1300151 L3 - citeulike-article-id:1300151 TI - Cerebral blood flow changes after treatment of social phobia with the neurokinin-1 antagonist GR205171, citalopram, or placebo. JF - Biol Psychiatry VL - 58 IS - 2 SP - 132 EP - 142 AD - Department of Psychology, Uppsala University, Uppsala, Sweden. tomas.furmark@psyk.uu.se SN - 0006-3223 N2 - BACKGROUND: Evidence is accumulating that pharmacological blockade of the substance P preferring neurokinin-1 (NK1) receptor reduces anxiety. This study compared the effects of an NK1 receptor antagonist, citalopram, and placebo on brain activity and anxiety symptoms in social phobia. METHODS: Thirty-six patients diagnosed with social phobia were treated for 6 weeks with the NK1 antagonist GR205171 (5 mg), citalopram (40 mg), or matching placebo under randomized double-blind conditions. GR205171 was administered for 4 weeks preceded by 2 weeks of placebo. Before and after treatment, regional cerebral blood flow (rCBF) during a stressful public speaking task was assessed using oxygen-15 positron emission tomography. Response rate was determined by the Clinical Global Impression Improvement Scale. RESULTS: Patients improved to a larger extent with the NK1 antagonist (41.7% responders) and citalopram (50% responders), compared with placebo (8.3% responders). Within- and between-group comparisons showed that symptom improvement was paralleled by a significantly reduced rCBF response to public speaking in the rhinal cortex, amygdala, and parahippocampal-hippocampal regions. The rCBF pattern was corroborated in follow-up analyses of responders and subjects showing large state anxiety reduction. CONCLUSIONS: Short-term administration of GR205171 and citalopram alleviated social anxiety. Neurokinin-1 antagonists may act like serotonin reuptake inhibitors by attenuating neural activity in a medial temporal lobe network. KW - neuroimaging KW - pet KW - pharmacotherapy KW - sad KW - treatment AU - Furmark, T AU - Appel, L AU - Michelgård, A AU - Wahlstedt, K AU - Ahs, F AU - Zancan, S AU - Jacobsson, E AU - Flyckt, K AU - Grohp, M AU - Bergström, M AU - Pich, EM AU - Nilsson, LG AU - Bani, M AU - Långström, B AU - Fredrikson, M PY - 2005/07/15/ UR - http://dx.doi.org/10.1016/j.biopsych.2005.03.029 ER -