is hypoactive at rest and increases in activity during symptom remission 15ĭorsolateral PFC appears to play a critical role in MDD through a defect in regulation of negative affect.lesions are associated with significantly higher MDD scores than for head injuries not involving the PFC 12.appears to play a role in regulating negative emotion through reappraisal/suppression strategies 13,14.is primarily associated with “cognitive” or “executive” functions 12.10 By enhancing serotonergic transmission, SSRIs can activate GABA interneurons, thereby dampening the noradrenergic and dopaminergic input. 9Įmotional blunting is related to SSRI dose, 9,10 and possibly serotonergic effects on the frontal lobes and/or serotonergic modulation of midbrain dopaminergic systems projecting to the prefrontal cortex (PFC). The primary effect of SSRIs is reduced processing of negative stimuli rather than increased positive stimuli. Higher doses of SSRI are more likely to cause emotional blunting 9,10 a cross-sectional study of 117 patients revealed that approximately 30% of patients reported some form of apathy 8.among 161 patients, 46% reported a narrowed range of affect, 21% reported an inability to cry, and 19% reported apathy 7. Nearly half of patients on all types of monoaminergic antidepressants report emotional blunting, 6 and it is associated with serotonin reuptake inhibitor (SSRI) therapy as follows: 2,5 5 More severe emotional blunting is associated with a poorer quality of remission. 4Įmotional blunting can impact everyday patient function and prevent a full functional recovery. 46% of patients on antidepressants report emotional bluntingĮmotional blunting is a residual symptom of MDD, which is a symptom experienced by patients with MDD despite antidepressant therapy.
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