Cookies on this website
We use cookies to ensure that we give you the best experience on our website. If you click 'Continue' we'll assume that you are happy to receive all cookies and you won't see this message again. Click 'Find out more' for information on how to change your cookie settings.

Depression is very common in adolescence and is associated with a high risk of recurrence and suicide. Adolescents with depression experience the same symptoms as adults, such as sadness and fatigue, but some key differences exist. Depressed youth often feel irritable rather than or in addition to feeling low.

Image shows girl sat with her head on her knees against the wall looking sad.

Despite being a common disorder, the pharmacological treatments available to treat depression in adolescence are scarce. Fluoxetine (or Prozac) is the only antidepressant licensed for use in the UK, still, very little is known about how this medication works in the brain of young people. This lack of knowledge constrains the development of new drugs.

A new study from the Psychopharmacology and Emotional Research Lab (PERL), A single dose of fluoxetine reduces neural limbic responses to anger in depressed adolescents, recently published in Translational Psychiatry, showed the effects of a single dose of fluoxetine on neural responses to emotional faces in depressed adolescents. Recent work from the PERL suggests that fluoxetine reduces the processing of anger, consistent with its effect for the treatment of irritability in young people (Capitão et al, 2015, Psychological Medicine). Hence, it could be predicted that fluoxetine would reduce the neural processing of angry faces.

Twenty-nine adolescents with Major Depressive Disorder (MDD), who had been recently prescribed fluoxetine by their psychiatrist, were randomised to receive their initial dose of 10mg fluoxetine vs. placebo. In line with predictions, after the single dose of fluoxetine, participants displayed reduced neural activity to angry facial expressions in a limbic region of the brain (a cluster that includes both the amygdala and the hippocampus), relative to placebo. Simultaneously, activity in the dorsal anterior cingulate cortex (dACC), known to be involved in self-regulation, was found to be increased. These results indicate that antidepressants may reduce the salience and/or increase the regulation of anger cues in young people with depression, right from the start of treatment.

The current study provides the first experimental evidence that, similarly to adults, antidepressants have immediate effects on emotional neural processing in young people within hours of administration and well before the therapeutic effects on mood emerge. The effect on anger is consistent with previous work and could therefore represent a key mechanism of action for subsequent improvement in symptoms of anger/irritability frequently seen in this population. Future studies should further explore the clinical implications of these effects, but it is hoped that these findings will assist the development of effective drug targets for adolescent depression, an area of research urgently needed.

Read the open-access paper in Translational Psychiatry.

NIHR OXFORD HEALTH BIOMEDICAL RESEARCH CENTRE NEWS

Please follow the link below to read the news on the NIHR BRC website.

Similar stories

What is the Role of Science in Mental Health?

A new summary report, What science has shown can help young people with anxiety and depression - Identifying and reviewing the 'active ingredients' of effective interventions, from Wellcome has been published. It includes new research from Oxford University, which investigates the knowns and unknowns of SSRI treatment (antidepressant drugs) in young people with depression and anxiety.

Depressive Symptoms and Risky Behaviours Among Adolescents in Low-and Middle-Income Countries

New meta-analysis, published in the Journal of the American Academy of Child & Adolescent Psychiatry, shows adolescents with depressive symptoms were more likely to engage in risky behaviours compared with non-depressed adolescents.

Adolescent Mental Health and Development in the Digital World

A new project has been awarded funding from the UKRI £24 million investment into improving the mental health and wellbeing of adolescents in the UK.

SSRI Treatment in Young People with Depression and Anxiety

Results from an insight review commissioned by the Wellcome Trust, highlights what is currently known about the benefits and risks of using selective serotonin reuptake inhibitors (SSRIs) for the treatment of depression and anxiety in young people.

Collaborating with Youth is Key to Studying Mental Health Management

The Global Mental Health Databank, a feasibility study, hopes to enable youth from the United Kingdom, South Africa, and India to work directly with mental health researchers to better understand how young people can manage their own mental health.

Almost 20% of COVID-19 Patients Receive Psychiatric Diagnosis within 90 Days

New study suggests that having COVID-19 increases a person’s risk of developing psychiatric disorders, and that having a psychiatric disorder increases the chance of getting COVID-19. The study, published in The Lancet Psychiatry, used the TriNetX electronic health records of 69 million people in the USA including over 62,000 cases of COVID-19.