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The goal of this crossover study was to learn about the potential regulatory role of serotonin in interoceptive processing and its relationship to levels of state anxiety. This experiment directly compared the impact of a selective serotonin reuptake inhibitor (SSRI) (20mg CITALOPRAM) to that of a PLACEBO on the neural processing of ordinary interoceptive sensations and the relationship of these influences to anxious states.
Healthy young volunteers completed the visceral interoceptive attention task with each treatment condition (citalopram and placebo). The task involves focusing attention on heart, stomach, or visual sensation control while scanned with functional magnetic resonance imaging (fMRI). The difference in haemodynamic response between interoceptive sensation(s) and visual sensation (i.e. the relative interoceptive response) is compared between treatment conditions. State anxiety is measured at each test period. It is used to test for a moderating effect of state anxiety on the influence of serotonin in interoceptive processing and used post-hoc to explore associations between changes in state anxiety and changes of interoceptive relative interoceptive response due to the SSRI.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| citalopram first, placebo second | Other | Citalopram was taken first. Placebo was taken at least 7 days later. |
|
| placebo first, citalopram second | Other | Placebo was taken first. Citalopram was taken at least 7 days later. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Citalopram 20mg | Drug | Doses were delivered in gelatine capsules filled with microcrystalline cellulose. |
|
| Measure | Description | Time Frame |
|---|---|---|
| relative neural interoceptive response - heart | Neural response, inferred via functional magnetic resonance imaging from focusing attention on the heart, minus the response during focus on a visual stimulus | 15 minutes |
| relative neural interoceptive response - stomach | Neural response, inferred via functional magnetic resonance imaging from focusing attention on the stomach, minus the response during focus on a visual stimulus | 15 minutes |
| State Anxiety | State Trait Anxiety Inventory | 5 minutes |
| Measure | Description | Time Frame |
|---|---|---|
| Metacognitive Interoceptive Insight | Ability of confidence to predict accuracy when making decisions about whether heartbeat is in sync with an auditory tone. This is an exploratory measure. | 45 minutes |
| Physiological and Psychological state |
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Inclusion Criteria:
- healthy volunteer
Exclusion criteria included:
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| Name | Affiliation | Role |
|---|---|---|
| Daniel Campbell-Meiklejohn, DPhil | University of Sussex | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| School of Psychology | Falmer | East Sussex | BN1 9QH | United Kingdom |
Anonymized data will be shared on a publically accessible database with a link accessible through the official publication.
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After publication
Public Access
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| ID | Term |
|---|---|
| D001008 | Anxiety Disorders |
| ID | Term |
|---|---|
| D001523 | Mental Disorders |
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| ID | Term |
|---|---|
| D015283 | Citalopram |
| ID | Term |
|---|---|
| D011437 | Propylamines |
| D000588 | Amines |
| D009930 | Organic Chemicals |
| D009570 | Nitriles |
| D001572 |
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| Placebo | Drug | Doses were gelatine capsules filled with microcrystalline cellulose |
|
Three scales (from 0-100) were given to assess three somatic side effects (nausea, headache and dizziness). Five anxiety-related effects (pairs of antonyms: alert-drowsy, stimulated-sedated, restless-peaceful, irritable-good-humoured, anxious-calm) were used to confirm other anxiety measures and alert the researchers to excessive side effects. Used to confirm anxiety measure detect side effects.
| Measured twice, for 2 minutes, before and after scanning. Average taken to estimate state inside scanner. |
| Positive and Negative Affect Scale | Measures affective state, confirming anxiety measure | Measured twice, for 2 minutes, before and after scanning. Average taken to estimate state inside scanner. |
| Heartrate | Participants had their heartrate recorded with the participant relaxed and sitting. | Before scans of each session, 2 minutes |
| Cerebral Blood Flow Change | Perfusion imaging, to control for effects of citalopram on blood flow | 2 minutes, at scan |
| Anatomical scan and fieldmaps | For coregistration of functional magnetic resonance images | 6 minutes, at scan |
| Benzofurans |
| D006574 | Heterocyclic Compounds, 2-Ring |
| D000072471 | Heterocyclic Compounds, Fused-Ring |
| D006571 | Heterocyclic Compounds |