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Experts say one of the side effects of common antidepressants is a condition known as emotional blunting. Luis Alvarez/Getty Images
  • Researchers say common antidepressants may cause a condition known as emotional blunting, which is characterized by a lack of feeling of both happiness and sadness.
  • They say the condition can also make it difficult for people to process feedback to complete tasks.
  • Experts say emotional blunting can affect a person’s daily life, including sexual activity.

Antidepressants may cause emotional blunting — a lack of feeling for both happiness and sadness — and make it less likely for people to use positive and negative feedback to complete tasks, according to a new study published in the journal Neuropsychopharmacology.

Researchers from the University of Cambridge looked at how people reacted to taking escitalopram (Lexapro), a well-tolerated SSRI antidepressant. There were 66 participants – 32 took escitalopram, and 34 took a placebo for at least 21 days.

At the end of the trial, participants received a series of cognitive tests assessing different cognitive functions, such as

  • Learning
  • Inhibition
  • Executive function
  • Reinforcement behavior
  • Decision-making

Some of the findings of the study were:

  • There were no significant differences in attention or memory between participants.
  • There were no differences in emotional processes.
  • There was reduced reinforcement sensitivity on two tasks in the group that took escitalopram.

“The lack of widespread cognitive harm from SSRIs confirmed in this study generally supports the use of SSRIs in patients at risk for cognitive side effects from other older anti-anxiety medications like benzodiazepines and antidepressants like tricyclics,” said Dr. David Merrill, a psychiatrist and director of the Pacific Neuroscience Institute’s Pacific Brain Health Center at Providence Saint John’s Health Center in California.

“Such patients could include older adults or those with health-related anxiety and depression, like survivors of heart attacks or head injuries,” he told Healthline.

Reinforced sensitivity is how people learn from their feedback from their actions and environment. The researchers showed participants two stimuli to test this – A and B.

  • If they chose A, they would receive a reward four out of five times.
  • If they chose B, they would receive a reward one out of five times.

The participants were not told these rules. They had to learn them. At some point, the probabilities switched. Participants needed to learn the new rule based on how they received rewards.

The researchers found that participants taking escitalopram were less likely to use positive and negative feedback to guide their learning of the task than those taking a placebo. This suggested to the scientists that the drug affected their sensitivity to rewards and their ability to respond accordingly.

The researchers also reported that the participants taking escitalopram had more trouble reaching orgasm during sex.

“I often tell patients that ‘antidepressants dull the passions, bad and good,’ says Dr. Alex Dimitriu a physician in Psychiatry and Sleep Medicine and founder of Menlo Park Psychiatry & Sleep Medicine in California and BrainfoodMD.

“The highs and lows can be attenuated, though fortunately, when someone is low, feeling less so is a generally positive direction,” he told Healthline. “As patients often worry about affective blunting, I explain that antidepressants do not block all feelings. Antidepressants can reduce pain and lead to more functional behaviors. In my work, I’ve had many patients report that with antidepressants, they ‘can see the potholes, just not have to drive through them.'”

“It should also be noted that people with depression can also feel blunted. It might not be medications that cause this but the underlying condition,” Dimitriu added.

Depression is a serious mental illness, according to the National Institute of Mental Illness.

It includes feelings of sadness, despair, and hopelessness that last more than two weeks.

Other symptoms include:

  • Irritability, frustration, or restlessness
  • Feelings of guilt, worthlessness, or helplessness
  • Loss of interest or pleasure in things and activities previously enjoyed
  • Decreased energy or fatigue
  • Difficulty concentrating, remembering, or making decisions
  • Difficulty sleeping, early morning awakening, or oversleeping
  • Changes in appetite or unplanned weight changes
  • Thoughts of death or suicide or suicide attempts
  • Aches or pains, headaches, cramps, or digestive problems without a clear physical cause

Not everyone experiences every symptom.

There are numerous effective treatments for depression.

However, “No two people are affected in the same way, and there isn’t a ‘one size fits all’ for treatment. It may take some trial and error to find the right treatment,” according to the National Institute of Mental Illness.

Treatments include:

“If the benefit from an SSRI like escitalopram is substantial, doctors may also recommend adding a second medication to counteract blunting from SSRIs,” Merrill said. “A typical example is bupropion. “The combined use of escitalopram plus bupropion is so well-known in medicine that it is often initiated by primary care doctors rather than behavioral health specialists.”

Experts say medication is just one part of treatment. Self-care is essential.

“The basis of all my work is an acronym called SSEMM – Sleep, Socialization, Exercise, Meditation, and Mediterranean diet,” Dimitriu said. “We are all biological creatures and it is hard to find peace or happiness until these needs are met, even with medication.”