According to a study published by English and Danish scientists, the antidepressants used in a significant way would cause in patients an “emotional dulling”, with a lesser feeling of emotions, whether positive or negative. The explanations of Joachim Müllner, psychiatrist and member of the committee of experts of Doctissimo.
Very widely prescribed in France, antidepressants are drugs intended to regulate the emotions of the patients who take them. According to a study published in the journal Neuropsychopharmacologythese drugs would also have side effects, by “smoothing” all the emotions.
No effect on cognition
The scientists recruited 66 volunteers who were divided into two groups. Participants were either given the study drug, escitalopram, a selective serotonin reuptake inhibitor, or a placebo for at least 21 days before taking a series of cognitive tests.
Results: In almost all tests, including those assessing attention and memory, the drug made no difference. Facts confirmed by the main author, Professor Barbara Sahakian of the University of Cambridge: “The drug does nothing negative on cognition – from this point of view it is very good“.
A more global impact on the organization
But a lower sensitivity to reinforcement learning was found. For example, in testing, participants were given two options to choose from, A or B. Selecting A would result in a reward four times out of five, while B was rewarded only one time out of five. After a few rounds, the volunteers learn to select A. Occasionally, the odds were reversed and the participant had to learn the new rule. The researchers found that the medication group was, on average, significantly slower to respond to these changes.
Additionally, in questionnaires, volunteers taking escitalopram also reported having more difficulty reaching orgasm during sex, another commonly reported side effect.
“60% of healthy volunteers less sensitive to positive and negative reactions”
In addition, the study revealed that 60% of healthy volunteers became less sensitive to positive and negative reactions after taking this molecule for three weeks. The “dulling” of negative emotions could be part of how drugs help people recover from depression, but could also explain a common side effect.
Professor Sahakian says he is worried about this result and the incentive not to treat himself that could result from it. “My concern is that people see this and think the message is don’t take drugs. This is exactly the kind of work we need, but it doesn’t affect everyone – everyone is unique and the treatments are still therapeutic“. She thus wishes to recall that he “there is no doubt that antidepressants are beneficial“for many patients.
The opinion of Dr Joachim Müllner, psychiatrist and member of the Doctissimo expert committee
“The blunting of affects, the decrease in emotional sensitivity, is an effect regularly described by patients who take antidepressants. However, this effect is not always experienced as an undesirable effect since for some people, depression is precisely synonymous with a painful increase in sensitivity with an “absence of filter”. In clinical practice, an effective antidepressant is often associated with a feeling of regaining energy, envy, a disappearance of psychomotor slowing but also with a feeling of distancing from the daily hassles that overwhelmed and which is experienced as beneficial.“explains the doctor first.
“Sometimes, however, on the contrary, this dulling effect can be experienced as negative because it leads to too much emotional “anaesthesia” with a feeling of being a bit like “in cotton”. This effect is all the more annoying when it maintains a blunting of affects already caused by the depression itself. A change of class of antidepressant may then be advised“he specifies.
“This very interesting study published in the eminent journal Nature therefore shows for the first time, a cognitive effect of serotonin reuptake inhibitor antidepressants which is: the decrease in learning by reinforcement, i.e. a decrease in the brain’s ability to learn due to its sensitivity to positive emotion in case of success or negative emotion in case of failure. And if the link is not yet proven, the researchers suggest that this effect could explain this blunting effect described by the patients. Finally, if a patient taking antidepressants experiences this effect as undesirable, it is important to talk to their prescribing doctor.“concludes the specialist.