Apathy associated with antidepressant drugs: a systematic review

Acta Neuropsychiatrica, Journal Year: 2023, Volume and Issue: 35(4), P. 189 - 204

Published: Jan. 16, 2023

Abstract Objectives: Administration of antidepressant drugs – principally selective serotonin reuptake inhibitors (SSRIs) may induce clinically significant ‘apathy’ which can affect treatment outcomes adversely. We aimed to review all relevant previous reports. Methods: performed a PUBMED search English-language studies, combining terms concerning psychopathology (e.g. apathy) and classes antidepressants SSRI). Results: According certain inclusion use DSM/ICD diagnostic criteria) exclusion presence clinical condition that criteria, 50 articles were eligible for review. Together, they suggest administration usually SSRIs an apathy syndrome or emotional blunting, i.e. decrease in responsiveness, circumstances would have triggered intense mood reactions prior pharmacotherapy. The reported prevalence antidepressant-induced ranges between 5.8 50%, 20 92%. Antidepressant-induced emerges independently diagnosis, age, outcome appears dose-dependent reversible. main strategy is dose reduction, though some data the usefulness with olanzapine, bupropion, agomelatine amisulpride, methylphenidate–modafinil–olanzapine combination. Conclusion: needs careful attention. Further systematic research needed investigate prevalence, course, aetiology, this important condition.

Language: Английский

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Catalyst for change: Psilocybin’s antidepressant mechanisms—A systematic review

Journal of Psychopharmacology, Journal Year: 2025, Volume and Issue: unknown

Published: Jan. 20, 2025

Background: Recent clinical trials suggest promising antidepressant effects of psilocybin, despite methodological challenges. While various studies have investigated distinct mechanisms and proposed theoretical opinions, a comprehensive understanding psilocybin’s neurobiological psychological is lacking. Aims: Systematically review potential psilocybin. Methods: Search terms were generated based on existing evidence related to mechanisms. Following Preferred Reporting Items for Systematic Reviews Meta-Analysis guidelines, 15 systematically reviewed, exploring therapeutic change principles such as brain dynamics, emotion regulation, cognition, self-referential processing, connectedness, interpersonal functioning. Results: Within supportive setting, psilocybin promoted openness, cognitive neural flexibility, greater ability acceptance emotional experiences. A renewed sense connectedness the self, others, world emerged key experience. Imaging consistently found altered characterized by reduced global within default mode network connectivity, alongside increased between-network connectivity. Conclusions: Together, these changes may create fertile yet vulnerable window change, emphasizing importance set, guidance. The results that context, induce leveraging interplay between common psychotherapeutic factors. This complements view purely pharmacological effects, supporting multileveled approach reflects relevant dimensions including neurobiological, psychological, environmental

Language: Английский

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28 days later: A prospective daily study on psychological well-being across the menstrual cycle and the effects of hormones and oral contraceptives

Psychological Medicine, Journal Year: 2025, Volume and Issue: 55

Published: Jan. 1, 2025

Abstract Background We aimed to study how hormonal status (oral contraceptive [OC] users vs naturally cycling [NC]) affects different dimensions and variability of psychological well-being, they relate sex hormone levels (estradiol, progesterone, testosterone). Methods Twenty-two NC participants 18 OC reported daily affective physical symptoms collected salivary samples across 28 days. Groups were compared using well-being averages (linear mixed models), day-to-day (Levene’s test), network models. Within participants, cycle phase effects time-varying associations between hormones assessed both person-centered mean change (subtracting from score) scores. Results Lowered was found for users’ agitation, risk-taking, attractiveness, energy levels. They showed lower overall ratings happiness, (range R 2 m = .004: .019) but also more relaxation, sexual desire, better sleep quality .005; .01) the group. The impact on varied significantly phases, with largest progesterone Conclusions Our results confirm that is associated a range domains beyond mood including levels, feelings risk taking, agitation. in versus fit ‘emotional blunting’ as possible mechanism behind OC’s side effects. findings show menstrual differentially influenced markers emphasize need adequately account cycle.

Language: Английский

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Emerging strategies and clinical recommendations for the management of novel depression subtypes

Expert Review of Neurotherapeutics, Journal Year: 2025, Volume and Issue: unknown, P. 1 - 21

Published: Feb. 27, 2025

Introduction The phenomenology of depression is characterized by a wide array emotional, cognitive, and physical symptoms that significantly disrupt an individual's life. Societal changes, driven technological advancements, economic pressures, environmental concerns including climate change, shifting cultural norms, have influenced how manifests understood. These developments led to the identification new subtypes, highlighting need for personalized treatment approaches based on individual underlying causes.

Language: Английский

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Polish-language adaptation of the Oxford Depression Questionnaire (ODQ)

Psychiatria i Psychologia Kliniczna, Journal Year: 2025, Volume and Issue: 24(3), P. 240 - 244

Published: Jan. 31, 2025

Emotional disorders associated with antidepressant treatment (e.g. anhedonia and emotional blunting) are significant clinical research concerns which influence effectiveness patients’ quality of life. Nearly one-third patients treated antidepressants report experiencing apathy, approximately 8% describing it as moderate to severe. Similarly, about 40% a loss motivation, 12% characterising this symptom or The Oxford Depression Questionnaire (ODQ) is standardised tool developed assess the severity, differentiation, duration related use selective serotonin reuptake inhibitors (SSRI) antidepressants, distinguishing them from core depressive symptoms, such anhedonia. ODQ consists 26 items divided into three sections, assessing weekly experiences, changes compared before illness, on functioning. This study presents Polish-language adaptation ODQ, deemed appropriate for both purposes, providing robust SSRI-induced aiding in differential diagnosis planning.

Language: Английский

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The lived experience of withdrawal from Selective Serotonin Reuptake Inhibitor (SSRI) antidepressants: A qualitative interview study

Health Expectations, Journal Year: 2024, Volume and Issue: 27(1)

Published: Jan. 9, 2024

Our knowledge of the broader impacts antidepressant withdrawal, beyond physical side effects, is limited. Further research needed to investigate lived experiences aid clinicians on how guide patients through process.

Language: Английский

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Development of a multivariate prediction model for antidepressant resistant depression using reward-related predictors

Frontiers in Psychiatry, Journal Year: 2024, Volume and Issue: 15

Published: March 25, 2024

Introduction Individuals with depression who do not respond to two or more courses of serotonergic antidepressants tend have greater deficits in reward processing and internalizing symptoms, yet there is no validated self-report method determine the likelihood treatment resistance based on these symptom dimensions. Methods This online case-control study leverages machine learning techniques identify differences self-reported anhedonia profiles antidepressant non-responders compared responders healthy controls, as an initial proof-of-concept for relating indicators medication responsiveness. Random forest classifiers were used a subset from set 24 predictors that distinguished among resistant, non-resistant, non-depressed individuals recruited ( N = 393). Feature selection was implemented refine model prediction improve interpretability. Results Accuracies full predictor models ranged .54 .71, while feature selected retained 3-5 generated accuracies .42 .70. Several performed significantly above chance. Sensitivity greatest after when only responders, reaching .82 3 predictors. The then explored using factor analysis at item level cluster data empirically driven structures. Discussion Non-responders displayed distinct along dimensions anxiety, anhedonia, motivation, cognitive function. should be replicated prospective cohort sample predictive validity; however, this demonstrates validity limited instrument distinguishing between resistant responsive profiles.

Language: Английский

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A web‐based survey on the occurrence of emotional blunting in patients with major depressive disorder in Japan: Patient perceptions and attitudes

Neuropsychopharmacology Reports, Journal Year: 2024, Volume and Issue: 44(2), P. 321 - 332

Published: April 14, 2024

Abstract Aims To determine the prevalence and impact of emotional blunting (EB) in patients with major depressive disorder (MDD) Japan, identify treatment needs for EB using patients' perceptions attitudes. Methods Eligible Japan (aged 18–59 years) who reported a diagnosis MDD antidepressant medication use >3 months were eligible to complete an online survey. The primary outcome was EB, self‐reported validated screening question. Secondary outcomes included correlation between symptoms (measured by Oxford Depression Questionnaire [ODQ]) scores on Patient Health 9‐item (PHQ‐9), Generalized Anxiety Disorder 7‐item (GAD‐7), Work Social Adjustment Scale (WSAS), EuroQol 5‐Dimension 5‐Levels questionnaire (EQ‐5D‐5L). Descriptive questions used explore attitudes toward EB. Results In total, 3376 analysis (56% male; 48% aged 50–59 years). Overall, 67.1% 10% rating these as severe. mean (SD) ODQ total score 78.2 (21.5), which increased worsening symptoms. There correlations PHQ‐9, GAD‐7, WSAS, EQ‐5D‐5L (correlation coefficients: 0.67, 0.55, 0.56, −0.51, respectively; all p < 0.0001). analyses showed that one‐third reporting did not tell their physician, two‐thirds finding distressing likely affect recovery. Conclusion is important clinical issue be considered alongside functional recovery when managing MDD.

Language: Английский

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Effectiveness of Vortioxetine for the Treatment of Emotional Blunting in Patients with Major Depressive Disorder Experiencing Inadequate Response to SSRI/SNRI Monotherapy in Spain: Results from the COMPLETE Study

Neuropsychiatric Disease and Treatment, Journal Year: 2024, Volume and Issue: Volume 20, P. 1475 - 1489

Published: July 1, 2024

Background: The multinational, open-label COMPLETE study (NCT03835715) investigated the effectiveness of vortioxetine in alleviating emotional blunting patients with major depressive disorder (MDD) experiencing inadequate response and while being treated a selective serotonin reuptake inhibitor (SSRI) or serotonin–noradrenaline (SNRI). This paper presents results for subgroup enrolled Spain. Methods: Patients MDD (n = 67) partial during monotherapy an SSRI SNRI were switched to (10– 20 mg/day) 8 weeks. primary outcome was blunting, assessed by Oxford Depression Questionnaire (ODQ). Results: After weeks vortioxetine, mean (SE) change ODQ total score from baseline − 26.0 (2.9) ( P < 0.001). Respective changes Montgomery–Åsberg Rating Scale (MADRS), Motivation Energy Inventory, Digit Symbol Substitution Test, Sheehan Disability (SDS) scores 14.9 (0.8), +34.2 (4.5), +6.3 (1.6), ‒9.0 (1.3) (all 0.001 vs baseline). At week 8, 70.4% no longer reported 53.7% had achieved remission their symptoms (defined as MADRS ≤ 10). Mediation analysis showed 77.1% SDS be direct effect improvement after switching vortioxetine. Adverse events 35 (52.2%), most commonly nausea (14 patients, 20.9%). 33/54 (61.1%) receiving mg/day. Conclusion: In this investigating Spanish who experienced on SSRI/SNRI monotherapy, significant improvements core (including anhedonia), sleep duration, motivation energy, cognitive performance, overall patient functioning observed treatment. Two-thirds over half at 8. Keywords: disorder, motivation, functioning,

Language: Английский

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Emotional blunting in patients with depression. Part II: relationship with functioning, well-being, and quality of life

Annals of General Psychiatry, Journal Year: 2022, Volume and Issue: 21(1)

Published: June 20, 2022

Abstract Background Emotional blunting is a common symptom in people with depression and an important factor preventing full functional recovery. This international survey investigated the experience of emotional acute remission phases from perspective patients healthcare providers. paper presents data on impact overall functioning health-related quality life patient perspective. Methods Respondents were adults diagnosed by physician, currently prescribed antidepressant, reporting during past 6 weeks. Assessments included Oxford Depression Questionnaire (ODQ), Functioning Assessment Short Test (FAST), World Health Organization-Five Well-being Index (WHO-5). Pearson correlation multivariate regression analyses applied to examine relationship between ODQ FAST scores. Results Data are available for 752 (62% female; mean age, 45 years). Mean total score was 94.8 phase ( n = 300) 85.7 those 452; possible maximum, 130). scores 47.0 33.5, respectively (possible 72). Patients had significantly greater impairment across all domains than (all differences, p < 0.01). WHO-5 6.4 9.8 phases, (lower indicate poorer well-being). Overall, 65% 36% reported that significant their life. analysis showed moderate positive r 0.52) weak negative − 0.26; both In analysis, (in combination other covariates) strongest predictor poor functioning. Conclusions has substantial patients’ daily functioning, well-being, depression. These findings highlight importance recognizing treating major depressive disorder order achieve

Language: Английский

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