Apathy associated with antidepressant drugs:: A systematic review
Apathy associated with antidepressant drugs:: A systematic review
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: We performed a PUBMED-search of English-language studies, combining terms concerning psychopathology (e.g. apathy) and classes of antidepressants (e.g. SSRI). Results: According to certain inclusion (e.g. use of DSM/ICD diagnostic criteria) and exclusion (e.g. presence of a clinical condition that may induce apathy) criteria, 50 articles were eligible for review. Together, they suggest that administration of antidepressants-usually SSRIs-can induce an apathy syndrome or emotional blunting, i.e. a decrease in emotional responsiveness to circumstances which would have triggered intense mood reactions prior to pharmacotherapy. The reported prevalence of antidepressant-induced apathy ranges between 5.8%-50%, and for SSRIs ranges between 20%-92%. Antidepressant-induced apathy emerges independently of diagnosis, age, and treatment outcome, and appears dose-dependent and reversible. The main treatment strategy is dose reduction, though some data suggest the usefulness of treatment with olanzapine, bupropion, agomelatine or amisulpride, or the methylphenidate-modafinil-olanzapine combination. Conclusion: Antidepressant-induced apathy needs careful clinical attention. Further systematic research is needed to investigate the prevalence, course, etiology, and treatment of this important clinical condition.
antidepressant drugs, apathy syndrome, emotional blunting, selective serotonin reuptake inhibitors
Masdrakis, Vasilios G.
f05d0f05-597e-400d-b86e-79bc0747848f
Markianos, Manolis
5749bfc6-366a-41bd-b1bf-d71e424e4cdf
Baldwin, David S.
1beaa192-0ef1-4914-897a-3a49fc2ed15e
16 January 2023
Masdrakis, Vasilios G.
f05d0f05-597e-400d-b86e-79bc0747848f
Markianos, Manolis
5749bfc6-366a-41bd-b1bf-d71e424e4cdf
Baldwin, David S.
1beaa192-0ef1-4914-897a-3a49fc2ed15e
Masdrakis, Vasilios G., Markianos, Manolis and Baldwin, David S.
(2023)
Apathy associated with antidepressant drugs:: A systematic review.
Acta Neuropsychiatrica.
(doi:10.1017/neu.2023.6).
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: We performed a PUBMED-search of English-language studies, combining terms concerning psychopathology (e.g. apathy) and classes of antidepressants (e.g. SSRI). Results: According to certain inclusion (e.g. use of DSM/ICD diagnostic criteria) and exclusion (e.g. presence of a clinical condition that may induce apathy) criteria, 50 articles were eligible for review. Together, they suggest that administration of antidepressants-usually SSRIs-can induce an apathy syndrome or emotional blunting, i.e. a decrease in emotional responsiveness to circumstances which would have triggered intense mood reactions prior to pharmacotherapy. The reported prevalence of antidepressant-induced apathy ranges between 5.8%-50%, and for SSRIs ranges between 20%-92%. Antidepressant-induced apathy emerges independently of diagnosis, age, and treatment outcome, and appears dose-dependent and reversible. The main treatment strategy is dose reduction, though some data suggest the usefulness of treatment with olanzapine, bupropion, agomelatine or amisulpride, or the methylphenidate-modafinil-olanzapine combination. Conclusion: Antidepressant-induced apathy needs careful clinical attention. Further systematic research is needed to investigate the prevalence, course, etiology, and treatment of this important clinical condition.
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Accepted/In Press date: 3 January 2023
e-pub ahead of print date: 16 January 2023
Published date: 16 January 2023
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© Scandinavian College of Neuropsychopharmacology 2023.
Keywords:
antidepressant drugs, apathy syndrome, emotional blunting, selective serotonin reuptake inhibitors
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Local EPrints ID: 474930
URI: http://eprints.soton.ac.uk/id/eprint/474930
ISSN: 0924-2708
PURE UUID: f3d65b26-a837-4e37-beda-af77e6dfb3af
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Date deposited: 07 Mar 2023 17:36
Last modified: 17 Mar 2024 07:40
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Author:
Vasilios G. Masdrakis
Author:
Manolis Markianos
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