Can antidepressant use be associated with emotional blunting in a subset of patients with depression? A scoping review of available literature

Abstract

Introduction Despite frequent recognition of emotional blunting in the published literature, either as a primary symptom of depression or as an adverse effect of antidepressants, there is no systematic synthesis on this topic to our knowledge. We undertook this scoping review to assess the prevalence, clinical features, implicated causes and management of emotional blunting, outlining the phenomenological and clinical gaps in research. Method A systematic search was done until March 15, 2022, to include all original studies (i.e., interventional trials, cohort & cross‐sectional studies, case reports, and case series). All reviewed data were delineated to answer pertinent clinical, phenomenological, and management questions related to the phenomenon of emotional blunting. Results A total of 25 original studies were included in our scoping review. Emotional blunting was described as a persistent diminution in both positive and negative feelings in depressed patients, who could subjectively differentiate it from their acute symptoms. However, the literature lacked the distinction between emotional blunting as a primary symptom of depression or an adverse effect of antidepressants. Common clinical strategies to manage antidepressant‐induced emotional blunting included dose reduction or switching to a different antidepressant. Conclusion Emotional blunting was a significant patient‐reported concern with antidepressants. Future research should clarify phenomenological and neurobiological constructs underlying emotional blunting to improve diagnostic and management skills.

SSRI Use Does Not Influence the Intensity of Romantic Love, Obsessive Thinking About a Loved One, Commitment, or Sexual Frequency in a Sample of Young Adults Experiencing Romantic Love

“…SSRIs function by reducing the reabsorption of serotonin into neurons and increasing intracellular serotonin levels (Etievant, Haddjeri, & Lau, 2020). They have downstream impacts on the dopamine system (Di Giovanni, Esposito, & Di Matteo, 2010) and are associated with a number of side effects, including sexual dysfunction (Rothmore, 2020) and a "blunting" of positive affect (Jawad et al, 2023).…”

Emotional Blunting in Depression in the PREDDICT Clinical Trial: Inflammation-Stratified Augmentation of Vortioxetine With Celecoxib

“…The latter has also been discussed in another study, where emotional blunting scores correlated with MADRS scores and were found to be lower in remitted than in nonremitted patients ( Aşçibaşi et al, 2020 ). Emotional blunting remains an important concern during antidepressant treatment ( Jawad et al, 2023 ).…”