Antidepressant-induced apathy was observed in all psychiatric disorders, especially in patients with dementia, and with all the SSRIs administered (citalopram, escitalopram, paroxetine, fluoxetine, sertraline).
Fifteen depressed patients treated with SSRIs (fluoxetine, paroxetine and sertraline) who had developed sexual dysfunctions, showed a high percentage of emotional blunting (80%), including a decrease of creativity, sexual pleasure, interest in sex, ability to cry, expression of their own feelings.
Apathy syndrome can occur in anyone receiving antidepressant therapy, but some individuals are at greater risk.
These drugs — including Prozac, Paxil, Zoloft, Celexa, and Lexapro — alter the way the body handles the “feel-good” brain chemical serotonin — a hormone responsible for regulating mood and happiness. As a result, things that once provoked strong reactions may now leave the same individual unaffected or even apathetic.
Chronic fluoxetine treatment may affect reward processing and induce anhedonia. Such side effects might pose a serious threat to patients' health and well-being.
Socially, fluoxetine is reported to make people feel more secure, give them a more outgoing personality and a dramatically different social life (Kramer, 1993). A contrast to this favorable evaluation is Breggin's (1994) report that fluoxetine causes agitation, irritability, excitement, impatience and belligerence.
Taking fluoxetine may affect your ability to do things that need a lot of focus, like exams. You should talk to your doctor about any future exams if you are starting fluoxetine.
, M.D., Ph. D. To the Editor: Apathy or amotivation, indifference, and loss of initiative have been reported in patients with major depressive disorder or panic disorder who take serotonin reuptake inhibitors (SSRIs). These symptoms occurred dose-dependently and were reversible when the SSRI was discontinued.
Sometimes, apathetic feelings are a result of things we can recognize and change—for example, we're feeling bored at work or we're no longer attracted to someone we once felt attracted to. But sometimes apathy is a symptom of a larger issue we're facing, like trauma, grief, or an underlying mental health condition.
SSRI-induced amotivational syndrome
Treatments include gradually reducing or discontinuing the SSRI, changing the SSRI to another antidepressant class, or co-prescribing with the SSRI a medication that boosts dopamine, such as the antidepressant bupropion.
Studies have shown that nearly half of people who take antidepressants experience emotional blunting.
If the feelings of apathy you experience are caused by something clearly identifiable, like a repetitive routine or burnout, it can be helpful to change up your routine. Try new things that challenge or fulfill you in different ways, such as a new hobby, a new exercise routine, or making new friends.
Findings suggest antidepressants may lead to impaired empathy of pain perception. Depression is a disorder that often comes along with strong impairments of social functioning.
Check with your doctor first before taking any other medicines with fluoxetine. Fluoxetine may cause some teenagers and young adults to be agitated, irritable, or display other abnormal behaviors. It may also cause some people to have suicidal thoughts and tendencies or to become more depressed.
It works by increasing the levels of serotonin in the brain. Serotonin is thought to have a good influence on mood, emotion and sleep. Fluoxetine helps many people recover from depression, and it has fewer side effects than some other antidepressants.
If you take Prozac to help manage depression, your symptoms may get worse before they get better. Although uncommon, this can include suicidal thoughts and behaviors, especially in people under 25 years old. Let your healthcare provider know right away if you notice changes in your mood or behavior.
Signs of apathy include: Disengaging or withdrawing from work, hobbies or spending time with loved ones. However, people with apathy appear to enjoy spending time with loved ones if they're pushed or persuaded to do so. A lack of concern that they've disengaged from activities they used to enjoy.
It is easy to get overwhelmed by the multitude of world problems, which is why allowing oneself to be apathetic from time to time is an important coping strategy.
Anxiety. While apathy and anxiety may appear to be separate, and different, states of being, there are many ways that severe anxiety can cause apathy. First, the emotional fatigue that so often accompanies severe anxiety leads to one's emotions being worn out, thus leading to apathy.
Apathy also has been recognized in the treatment with selective serotonin reuptake inhibitor (SSRI). It is explained that excessive serotonin inhibit frontal function directly and indirectly. Apathy which is misdiagnosed to depression can be worsen by starting or increasing SSRI.
For most people, antidepressants are the main cause of emotional blunting. In most cases, feelings of numbness go away when you stop taking the antidepressant that is causing you to feel this way. If you feel emotionally numb, it's important to tell your doctor.
One of the widely-reported side effects of SSRIs is 'blunting', where patients report feeling emotionally dull and no longer finding things as pleasurable as they used to.
Although some people may experience some negative fluoxetine side effects such anxiety, agitation, nausea and drowsiness, most people who take it don't experience serious side effects.
Fluoxetine, but not other selective serotonin uptake inhibitors, increases norepinephrine and dopamine extracellular levels in prefrontal cortex. Psychopharmacology (Berl).
Long-term side effects
Sexual side effects, such as problems getting an erection or a lower sex drive, have been reported after taking fluoxetine for a long time. In some cases, these can continue even after stopping the medicine.