A Dissociation of the Acute Effects of Bupropion on Positive Emotional Processing and Reward Processing in Healthy Volunteers.

Annabel E L Walsh,Randi Brown,Michael Browning,Phil Cowen,Catherine J Harmer,Nathan T M Huneke

doi:10.3389/fpsyt.2018.00482

Abstract

Background: 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.Methods: 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.Results: 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.Conclusions: 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.

Highlights

MATERIALS AND METHODSPatients suffering from major depressive disorder (MDD) display negative biases in emotional processing across a range of cognitive domains, including perception, attention, and memory [1,2,3,4]
Acute or 7 day administration of the selective serotonin reuptake inhibitor citalopram or the noradrenaline reuptake inhibitor reboxetine was found to increase the recall of positive self-referent words and the perception of ambiguous faces as happy in both healthy volunteers [8,9,10] and MDD patients [11] in the absence of any changes in mood
There were no significant differences between treatment groups with regards to gender, age, National Adult Reading Test (NART)-derived verbal IQ and baseline scores on the Hamilton Rating Scale for Depression (HAM-D) and self-report questionnaires (Table S1)

Summary

Introduction

MATERIALS AND METHODSPatients suffering from major depressive disorder (MDD) display negative biases in emotional processing across a range of cognitive domains, including perception, attention, and memory [1,2,3,4]. Acute or 7 day administration of the selective serotonin reuptake inhibitor citalopram or the noradrenaline reuptake inhibitor reboxetine was found to increase the recall of positive self-referent words and the perception of ambiguous faces as happy in both healthy volunteers [8,9,10] and MDD patients [11] in the absence of any changes in mood. 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. 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

Objectives

Results

Conclusion