New insights into the prospective efficacy and negative effects of widely used antidepressants suggest that they may cause emotional blunting.
Three weeks of treatment with a selective serotonin reuptake inhibitor (SSRI) medication reduced the sensitivity of healthy volunteers to both positive and negative feedback. One possible mechanism by which antidepressants aid in recovery from depression is by reducing the intensity of negative emotions.
People Who Use Antidepressants Experience ‘Emotional Blunt’
Prof. Barbara Sahakian from the University of Cambridge, the work’s senior author, said, “In a way, this may be part of how they work. They alleviate some of the sufferings that depressed people experience emotionally, but they also seem to dull some of the pleasures of life.
She noted, “there is no doubt that antidepressants are useful” for many patients, therefore the findings could help patients make better-informed prescription decisions.
More than 8.3 million people in England were prescribed an antidepressant by the NHS in 2020–2021. Antidepressants, of which SSRIs are a common type, are generally beneficial for most patients but not all.
One study found that 40-60% of those using the medicine experienced emotional dullness or a decrease in their ability to find pleasure in previously rewarding activities. It is not known, however, whether this symptom is a side effect of the medication or a sign of depression.
Evidence from recent studies indicates that exposure to the medication alone can cause emotional numbing. Sixty-six participants were randomly assigned to receive either escitalopram (an SSRI) or a placebo for at least 21 days before taking a battery of cognitive tests; the results were published in the journal Neuropsychopharmacology.
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Cause Of Common Side Effect
Positive and negative feedback are essential to reinforcement learning, however, those on the SSRI showed less receptivity to the task. There were two choices, A and B, shown to the participants on the screen.
Choose A four out of five times, and you’ll get a reward, but choose B just once out of five times.
People quickly pick A as the best option after a few rounds. The participant had to adapt to a new rule in which the odds were always different. On average, those on SSRIs reacted much more slowly to the shifts in feedback.
Professor Catherine Harmer of Oxford University noted that the article provided patient-relevant insights into the action of SSRI medicines and could lead to the development of therapies with a reduced side-effect profile.
Having “an objective assessment of what patients are telling us is a side-effect,” she remarked, “is incredibly useful.” “Once a metric has been established, it will be possible to examine the impact that different treatments have on the metric.”
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