What Is Emotional Blunting and Why Does It Happen?
These drugs, including fluoxetine (Prozac), paroxetine (Paxil), sertraline (Zoloft), citalopram (Celexa), and escitalopram (Lexapro), alter the way the body handles the “feel-good” brain chemical, serotonin. This is a hormone responsible for regulating mood and happiness. As a result, things that once provoked strong reactions may now leave the same individual unaffected or even apathetic.
One risk of blunting is that people may stop taking medications. “These people may begin to fear they cannot experience joys and pleasures,” says D. Bradford Reich, MD, a staff psychiatrist at McLean Hospital in Boston, and a senior investigator for Harvard Medical School’s Laboratory for the Study of Adult Development.
The research team theorized that SSRIs interfere with “reinforcement learning.” Think of this as the process of building knowledge by trial and error, or a feedback loop that sends either a positive or negative message to the brain.
“Many cognitive (thinking) functions were not affected by chronic SSRI use, but the impact on reinforcement learning underscores the role serotonin plays in the perception of rewarding and punishing feedback,” says Dr. Langley, who was a lead researcher for the study. Just how that process actually works remains unknown.
Norepinephrine and dopamine reuptake inhibitors (NDRIs) such as bupropion (Wellbutrin, Zyban, or Aplenzin) also affect serotonin to an extent but were not included in the study, notes Dr. Reich, who was not affiliated with the study. Some doctors prescribe these kinds of antidepressants to help avoid emotional blunting and related sexual side effects, he adds.
“You rarely find this blunting with Wellbutrin, which mostly affects noradrenaline and dopamine,” he says.
Drugs that target other brain chemicals are also believed to be less likely to flatten feelings, Reich adds. They can include tricyclic antidepressants (TCAs), monoamine oxidase inhibitors (MAOs), and other older antidepressant formulations.
That said, more research is needed to confirm this, since no head-to-head comparisons of which antidepressants are most or least associated with emotional blunting exist right now.
Source link
