Walsh Annabel E L, Huneke Nathan T M, Brown Randi, Browning Michael, Cowen Phil, Harmer Catherine J
NIHR Oxford Health Biomedical Research Centre, Warneford Hospital, Oxford, United Kingdom.
Psychopharmacology and Emotion Research Laboratory, Department of Psychiatry, University of Oxford, Oxford, United Kingdom.
Front Psychiatry. 2018 Oct 16;9:482. doi: 10.3389/fpsyt.2018.00482. eCollection 2018.
Previous research indicates that antidepressants can restore the balance between negative and positive emotional processing early in treatment, indicating a role of this effect in later mood improvement. However, less is known about the effect of antidepressants on reward processing despite the potential relevance to the treatment of anhedonia. In this study, we investigated the effects of an acute dose of the atypical antidepressant (dual dopamine and noradrenaline reuptake inhibitor) bupropion on behavioral measures of emotional and reward processing in healthy volunteers. Forty healthy participants were randomly allocated to double-blind intervention with either an acute dose of bupropion or placebo prior to performing the Emotional Test Battery (ETB) and a probabilistic instrumental learning task. Acute bupropion significantly increased the recognition of ambiguous faces as happy, decreased response bias toward sad faces and reduced attentional vigilance for fearful faces compared to placebo. Bupropion also reduced negative bias compared to placebo in the emotional recognition memory task (EMEM). There was no evidence that bupropion enhanced reward processing or learning. Instead, bupropion was associated with reduced likelihood to choose high-probability wins and increased score on a subjective measure of anhedonia. Whilst acute bupropion decreases negative and increases positive emotional processing, it has an adverse effect on reward processing. There seems to be a dissociation of the acute effects of bupropion on positive emotional processing and reward processing, which may have clinical implications for anhedonia early in treatment.
先前的研究表明，抗抑郁药在治疗早期可恢复负面和正面情绪处理之间的平衡，表明这种效应在后期情绪改善中发挥作用。然而，尽管抗抑郁药对奖赏处理的影响可能与快感缺失的治疗相关，但目前对此了解较少。在本研究中，我们调查了急性剂量的非典型抗抑郁药（多巴胺和去甲肾上腺素双重再摄取抑制剂）安非他酮对健康志愿者情绪和奖赏处理行为指标的影响。40名健康参与者在进行情绪测试电池组（ETB）和概率性工具学习任务之前，被随机分配接受急性剂量的安非他酮或安慰剂的双盲干预。与安慰剂相比，急性给予安非他酮显著增加了将模棱两可的面孔识别为快乐的比例，降低了对悲伤面孔的反应偏差，并降低了对恐惧面孔的注意力警觉性。在情绪识别记忆任务（EMEM）中，与安慰剂相比，安非他酮也减少了负性偏差。没有证据表明安非他酮增强了奖赏处理或学习。相反，安非他酮与选择高概率获胜的可能性降低以及快感缺失主观测量得分增加有关。虽然急性给予安非他酮可减少负面情绪并增加正面情绪处理，但它对奖赏处理有不利影响。安非他酮对正面情绪处理和奖赏处理的急性效应似乎存在分离，这可能对治疗早期的快感缺失具有临床意义。
