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Marcia Kauer-Sant'Anna, Lakshmi N. Yatham, Juliana Tramontina, Fernanda Weyne, Keila Maria Cereser, Fernando Kratz Gazalle, Ana Cristina Andreazza, Aida Santin, Joao Quevedo, Ivan Izquierdo, and Flavio Kapczinski
Emotional memory in bipolar disorder
The British Journal of Psychiatry 2008; 192: 458-463 [Abstract] [Full text] [PDF]
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[Read eLetter] Confounding effect of antipsychotic medication on emotional processing should be taken into account
Ayana A Gibbs   (3 September 2008)

Confounding effect of antipsychotic medication on emotional processing should be taken into account 3 September 2008
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Ayana A Gibbs,
Clinical Researcher
Institute of Psychiatry

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Re: Confounding effect of antipsychotic medication on emotional processing should be taken into account

a.gibbs{at}iop.kcl.ac.uk Ayana A Gibbs

Kauer-Sant’Anna and colleagues investigated episodic emotional memory in bipolar disorder and found, in contrast to their predictions, an absence of the emotional enhancement of memory observed in controls (1). However, it is of note that all of their patients were taking mood stabilising psychotropic medication and half were taking antipsychotics at the time of testing. While the authors acknowledge the potential effects of medication on emotional memory, they also cite evidence of the “only study to date that assessed the effects of a psychotropic medication sulpiride in ‘normal’ human volunteers” having found no effect on emotional enhancement of memory (2). It is also of note that although this study by Mehta and colleagues, which was hampered by a small sample size, did not find a statistically significant impairment of emotional enhancement of memory there were notable trend effects in this direction. We have recently published data demonstrating the effect of the antipsychotic amisulpride in attenuating emotional memory (3). Whether this is related to its therapeutic effect is unclear. However, what is clear is that attributing cognitive differences between patients and controls to disease processes without adequately accounting for the effects of medication is likely to be misleading.

1. Kauer-Sant'Anna M, Yatham LN, Tramontina J, Weyne F, Cereser KM, Gazalle FK, Andreazza AC, Santin A, Quevedo J, Izquierdo I, Kapczinski F: Emotional memory in bipolar disorder. The British Journal of Psychiatry 2008; 192(6):458-463

2. Mehta MA, Hinton EC, Montgomery AJ, Bantick RA, Grasby PM: Sulpiride and mnemonic function: Effects of a dopamine D2 receptor antagonist on working memory, emotional memory and long-term memory in healthy volunteers. Journal of Psychopharmacology 2005; 19(1):29-38

3. Gibbs A, Naudts K, Spencer E, David A: The role of dopamine in attentional and memory biases for emotional information. American Journal of Psychiatry 2007; 164(10):1603-1609