How do you manage emotional blunting due to SSRIs/SNRIs?  

As with other classes of psychotropic medication, I have found that even though two medications may be in the same class, a particular patient may experience different responses to them, both in effectiveness and/or side effects. So, if that occurs, I will often try another medication in the same cl...

Emotional blunting due to SSRIs, and possibly SNRIs, is a common problem that our profession has been somewhat slow to recognize, perhaps because patients experiencing this side effect are by definition, less likely to complain. It is often noticed by family members. SSRI-induced emotional blunting ...

Augmentation with a non-stimulant dopaminergic can also be quickly helpful. Using pramipexole or amantadine has been helpful and generally very well tolerated. Explaining the relationship between serotonin and dopamine in pre-frontal circuitry makes this approach a bit easier to explain to patients,...

As far as optimizing medications, the various suggestions for reducing the dose and consideration of augmentation, switching antidepressants, or adding dopaminergic drugs are worthwhile strategies. But there are a few patients who go from extremely depressed to near-remission and complain of an emo...

I agree with all the above suggestions from my colleagues. I’ve tried them all over the 30 years I’ve been in the field, including even Cytomel. We absolutely have to realize that each patient’s brain chemistry and neurocircuitry are unique and respond differently to different medi...

I remain skeptical about actual "emotional blunting". A small minority of my patients report this. In my opinion, they seem to be reporting a subjectively reduced negative emotional reactivity, which they are afraid will also result in a reduced overall emotional reactivity, but I am not persuaded t...

Dr. Conlon's astute comment and encouragement to bring us back to the process of careful observation and engagement with the patient is core.  When I can get a specific, repeated scenario in which the patient feels emotionally dampened, we can return to that scenario to pick up on improvement -...