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Emotional side-effects of selective serotonin reuptake inhibitors: qualitative study
Open accessAbstract
Background: Some people who take selective serotonin reuptake inhibitor (SSRI) antidepressants report that their experience of emotions is ‘blunted’. This phenomenon is poorly understood. Aims: To understand patients' experiences of this phenomenon. Method: Qualitative study, gathering data through individual interviews, a group interview and validation interviews; and searching patient websites for relevant posts. Results: There was strong evidence that some people taking SSRIs experience significant emotional symptoms that they strongly attribute to their antidepressant. These emotional symptoms can be described within six key themes. A seventh theme represents the impact of these side-effects on everyday life, and an eighth represents participants' reasons for attributing these symptoms to their antidepressant. Most participants felt able to distinguish between emotional side-effects of antidepressants and emotional symptoms of their depression or other illness. Conclusions: Emotional side-effects of SSRIs are a robust phenomenon, prominent in some people's thoughts about their medication, having a demonstrable impact on their functioning and playing a role in their decision-making about antidepressant adherence.
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“Emotional blunting is clinically important as it affects patients' functioning in work life, social life, and family life, and thus prevents full functional recovery (Price et al., 2009).”
From Effectiveness of Vortioxetine on Emotional Blunting in Patients with Major Depressive Disorder with inadequate response to SSRI/SNRI treatment (2021) · cites this paper as Price et al., 2009
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Many patients diagnosed with MDD and treated with SSRIs described a restriction or diminution in the intensity or frequency of emotions common in everyday living and essential for daily functioning (24, 25).”
From Emotional Blunting in Patients With Major Depressive Disorder: A Brief Non-systematic Review of Current Research (2021) · cites this paper as [25]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“For example, in one qualitative study, experimenters interviewed 220 participants who had been depressed and were either taking or had taken SSRIs (25). Most respondents specifically attributed the numbing of emotions to their medication.”
From Emotional Blunting in Patients With Major Depressive Disorder: A Brief Non-systematic Review of Current Research (2021) · cites this paper as [25]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Some patients noticed reduced emotional responses while on their SSRIs and returned to their normal emotional states after discontinuing the medication or lowering the dose (25).”
From Emotional Blunting in Patients With Major Depressive Disorder: A Brief Non-systematic Review of Current Research (2021) · cites this paper as [25]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“It has been suggested that emotional blunting may be an adverse effect associated with certain classes of antidepressants; for example, up to 60% of patients treated with SSRIs or SNRIs report some degree of emotional blunting [8–11].”
From Emotional blunting in patients with depression. Part I: clinical characteristics (2022) · cites this paper as [8]
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In the citing paper
“Anhedonia (i.e., the inability to experience pleasure) is a common symptom of depression and other mental health disorders [8, 16].”
From Emotional blunting in patients with depression. Part I: clinical characteristics (2022) · cites this paper as [8]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“The results have important clinical implications as they may reflect the blunting effect often reported by patients with neuropsychiatric disorders receiving chronic SSRI treatment.”
From Chronic escitalopram in healthy volunteers has specific effects on reinforcement sensitivity: a double-blind, placebo-controlled semi-randomised study (2023) · cites this paper as [41]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Lower reinforcement sensitivity in response to chronic SSRI administration may reflect the ‘blunting’ effect often reported by patients with MDD treated with SSRIs.”
From Chronic escitalopram in healthy volunteers has specific effects on reinforcement sensitivity: a double-blind, placebo-controlled semi-randomised study (2023) · cites this paper as [41]
Experimental — accuracy not yet measuredThe cited source says what the claim attributes to it.
In the citing paper
“Emotional blunting is regularly reported in depressed patients on antidepressant treatment but its actual frequency is poorly understood.”
From Emotional blunting with antidepressant treatments: A survey among depressed patients (2017) · cites this paper as Price et al., 2009
The cited source says what the claim attributes to it.
In the citing paper
“The questionnaire was systematically constructed on the basis of qualitative assessments of emotional blunting in patients on SSRIs using data collected in individual interviews and from patient websites (Price et al., 2009).”
From Emotional blunting with antidepressant treatments: A survey among depressed patients (2017) · cites this paper as Price et al., 2009
The cited source says what the claim attributes to it.
In the citing paper
“many patients strongly attribute their emotional symptoms either in total or in part to their medication (25).”
From Emotional Blunting in Patients With Major Depressive Disorder: A Brief Non-systematic Review of Current Research (2021) · cites this paper as [25]
The cited source says what the claim attributes to it.
In the citing paper
“Patients who suffer from emotional blunting are subject to a reduction in a broader range of emotions, including love, affection, fear, and anger (25).”
From Emotional Blunting in Patients With Major Depressive Disorder: A Brief Non-systematic Review of Current Research (2021) · cites this paper as [25]
The cited source says what the claim attributes to it.
In the citing paper
“However, several patients were uncertain whether it was the SSRI they took or changes in life events that had caused their emotional blunting.”
From Emotional Blunting in Patients With Major Depressive Disorder: A Brief Non-systematic Review of Current Research (2021) · cites this paper as [25]
The cited source says what the claim attributes to it.
In the citing paper
“Patients with emotional blunting very frequently experience anhedonia; however, the emotions that are blunted are not limited to pleasure, and other emotions, including negative emotions, are also blunted or toned down [8].”
From Emotional blunting in patients with depression. Part I: clinical characteristics (2022) · cites this paper as [8]
The cited source says what the claim attributes to it.
In the citing paper
“Patients’ often report experiencing a ‘blunting’ effect [40–42].”
From Chronic escitalopram in healthy volunteers has specific effects on reinforcement sensitivity: a double-blind, placebo-controlled semi-randomised study (2023) · cites this paper as [41]
In the citing paper
“However, it has been shown that most antidepressant users can distinguish accurately between symptoms of the original disorder and adverse drug effects.50”
From Protracted withdrawal syndrome after stopping antidepressants: a descriptive quantitative analysis of consumer narratives from a large internet forum (2020) · cites this paper as [50]
In the citing paper
“Small scale qualitative research has often highlighted negative experiences [11–14] or noted considerable ambivalence amongst some antidepressant users [15, 16].”
From ‘In my life antidepressants have been…’: a qualitative analysis of users’ diverse experiences with antidepressants (2016) · cites this paper as [13]
In the citing paper
“A potential detrimental manifestation of long-term treatment with antidepressants may be the emotional blunting phenomenon (vide infra) or otherwise 'depressogenic' phenomena [33-36].”
In the citing paper
“A high proportion of patients receiving SSRIs may exhibit a clinical phenomenon referred to as emotional blunting.”
In the citing paper
“It was proposed that current standard treatment of MDD, particularly selective serotonin reuptake inhibitors (SSRIs), fail to sufficiently treat reward-related symptoms of depression (Dunlop and Nemeroff, 2007; Price et al., 2009; Di Nicola et al., 2013).”
From Circuit Mechanisms of Reward, Anhedonia, and Depression (2019) · cites this paper as Price et al., 2009
In the citing paper
“These results could reflect the fact that anhedonia has a rather low response to SSRI treatment compared with other symptoms (Opbroek et al., 2002; Price et al., 2009).”
From Circuit Mechanisms of Reward, Anhedonia, and Depression (2019) · cites this paper as Price et al., 2009
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A.E. Vaaler & O.B. Fasmer respond:
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Metadata
- Authors
- Price, J., Cole, V., & Goodwin, G. M.
- Affiliations
- Warneford Hospital (GB)
- Corresponding author
- Price, Jonathan
- Venue
- British Journal of Psychiatry
- Publisher
- Royal College of Psychiatrists
- Published
- 2009-09
- Volume
- 195
- Issue
- 3
- Pages
- 211-217
- ISSN
- 0007-1250 (ISSN-L)
- 1472-1465
- OpenAlex
- W2150537415
- Cited by
- 362
- References
- 16
- Citations by year
- 2026: 31 · 2025: 18 · 2024: 25 · 2023: 28 · 2022: 42 · 2021: 16 · 2020: 22 · 2019: 14 · 2018: 15 · 2017: 29 · 2016: 20 · 2015: 25 · 2014: 15 · 2013: 17 · 2012: 14
- FWCI
- 10.78
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The British Journal of Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Funders
- University of Oxford
- Servier
- Topics
- Health Sciences › Medicine › Pharmacology (medical) › Treatment of Major Depression
- Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
- Health Sciences › Medicine › Psychiatry and Mental health › Electroconvulsive Therapy Studies
- Keywords
- selective serotonin reuptake inhibitors, antidepressant side effects, emotional blunting, emotional symptoms, patient experience, antidepressant adherence, depression, impact on daily life
- MeSH terms
- Adult, Aged, Aged, 80 and over, Depressive Disorder, Emotions, Female, Humans, Male, Middle Aged, Personality, Psychiatric Status Rating Scales, Patient Satisfaction, Selective Serotonin Reuptake Inhibitors, Internet, Young Adult
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