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BACKGROUND: The neuropharmacological actions of antidepressants are well characterised but our understanding of how these changes translate into improved mood are still emerging. AIMS: To investigate whether actions of antidepressant drugs on emotional processing are a mediating factor in the effects of these drugs in depression. METHOD: We examined key published findings that explored the effects of antidepressants on behavioural and functional magnetic resonance imaging (fMRI) measures of emotional processing. RESULTS: Negative emotional bias has been reliably associated with depression. Converging results suggest that antidepressants modulate emotional processing and increase positive emotional processing much earlier than effects on mood. These changes in emotional processing are associated with neural modulation in limbic and prefrontal circuitry. CONCLUSIONS: Antidepressants may work in a manner consistent with cognitive theories of depression. Antidepressants do not act as direct mood enhancers but rather change the relative balance of positive to negative emotional processing, providing a platform for subsequent cognitive and psychological reconsolidation.

Original publication

DOI

10.1192/bjp.bp.108.051193

Type

Journal article

Journal

Br J Psychiatry

Publication Date

08/2009

Volume

195

Pages

102 - 108

Keywords

Affect, Antidepressive Agents, Cognition, Depressive Disorder, Emotions, Facial Expression, Humans, Limbic System, Magnetic Resonance Imaging, Models, Neurological, Models, Psychological, Negativism, Time Factors