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Sansone, 2010 SSRI-Induced Indifference


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Psychiatry (Edgmont). 2010 Oct;7(10):14-8.

SSRI-Induced Indifference.

Sansone RA, Sansone LA.

 

Source Dr. R. Sansone is a professor in the Departments of Psychiatry and Internal Medicine at Wright State University School of Medicine in Dayton, Ohio, and Director of Psychiatry Education at Kettering Medical Center in Kettering, Ohio.

 

Abstract at http://www.ncbi.nlm.nih.gov/pubmed/21103140 Free full text at http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2989833/?tool=pubmed and http://www.mediafire.com/?ct5wlqzh7s3chw5

 

Abstract

 

In the existing literature, selective serotonin reuptake inhibitor exposure has been occasionally associated with both behavioral apathy and emotional blunting. While frequently described as separate entities, these two syndromes are mutually characterized by indifference and may be united under the single moniker, "selective serotonin reuptake inhibitor-induced indifference." Little is known about the epidemiology or etiology of selective serotonin reuptake inhibitor-induced indifference and few empirical studies have been undertaken. However, this syndrome may be under-recognized by both clinicians and patients (i.e., low insight, particularly among children and adolescents), and is characterized by an insidious onset, dose-dependent effects (i.e., higher selective serotonin reuptake inhibitor doses are more likely to result in symptoms), and complete resolution of symptoms with the discontinuation of the offending drug. Treatment strategies may include a dose reduction of the offending selective serotonin reuptake inhibitor, augmentation with a second drug, and/or discontinuation of the selective serotonin reuptake inhibitor and subsequent treatment with a nonselective serotonin reuptake inhibitor antidepressant.

 

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From the paper:

 

....

As for prevalence rates, according to a study by Bolling and Kohlenberg,9 approximately 20 percent of 161 patients who were prescribed an SSRI reported apathy and 16.1 percent described a loss of ambition.9 In a study by Fava et al,10 which consisted of participants in both the United States and Italy, nearly one-third on any antidepressant reported apathy, with 7.7 percent describing moderate-to-severe impairment, and nearly 40 percent acknowledged the loss of motivation, with 12.0 percent describing moderate-to-severe impairment.10 In a third study, researchers examined 43 pediatric patients with anxiety disorders and noted that five percent of the study sample developed apathy while taking fluvoxamine.3

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From the paper:

 

....

As for prevalence rates, according to a study by Bolling and Kohlenberg,9 approximately 20 percent of 161 patients who were prescribed an SSRI reported apathy and 16.1 percent described a loss of ambition.9 In a study by Fava et al,10 which consisted of participants in both the United States and Italy, nearly one-third on any antidepressant reported apathy, with 7.7 percent describing moderate-to-severe impairment, and nearly 40 percent acknowledged the loss of motivation, with 12.0 percent describing moderate-to-severe impairment.10 In a third study, researchers examined 43 pediatric patients with anxiety disorders and noted that five percent of the study sample developed apathy while taking fluvoxamine.3

....

 

 

First time I've ever heard myself described! Apathy, yes... loss of motivation, a big yes. I was acutely aware of this, but didn't think of it as "symptoms", and therefore, didn't attribute apathy or low motivation to an AD.

 

I always thought it was me... getting older or whatever... omg.

 

 

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Altostrata

This was the major reason I wanted to get off Paxil.

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

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This was the major reason I wanted to get off Paxil.

 

How did you know it was Paxil, and not something else? My guess is that you're going to say you remb how it was before Paxil. I do too. Things were easier of course, tho I was never a highly motivated person... so, I thought it was just me.

 

I think this site is going to help a lot of people, at least to understand what is going on with them.

 

 

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I knew it was the Paxil because I just got more and more and more sluggish as time went on, didn't care about anything, and had no motivation at all. (There were the sexual side effects, too.)

 

No, it didn't feel like it was me. I was always cooking up little projects before Paxil.

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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  • Altostrata changed the title to Sansone, 2010 SSRI-Induced Indifference
  • 1 year later...
crashcourse

I can definitely say SSRI and SNRI have impacted my motivation. SSRI for sure. I got my first short story pubbed by an excellent literary magazine soon after I started citalopram. I still remember the day - and how I was unable to feel any joy. It has stuck with me, since I was so looking forward to it, but nada, no emotions - just a blank.

2012- Citalopram 40- Axal 0.5mg  2017- Stopped Axal CT. No WD.

2017 - Effexor XR 75 mg.

For Epilepsy:1983 - Tegral 400 mg/day  2009 - Lumark 1000 mg/day- Biotim eyedrops for glaucoma.

27 April 2019 - Effexor XR taper started. 40 beads removed - 16% - 63mg20 May - 10% - 20 beads. 57mg / 3 June - 10% - 20 beads - 51mg / 18 July - 6% -10 beads - 48mg / 20 July - 7% -10 beads- 44.5mg/ 1 Sept - 75 mg alternate days = 37.5 mg/ 14 Sept - 75 mg every 3rd day = 25mg/  22 Sept - Effexor XR stopped.

27 Oct - Tegral = 300mg. Citalopram = 30 mg. Lumark = 500mg Busron = 10 mg. Somna = 2.5 mg

1-Jan 2020 Tegral 200mg BD- Citalopram 20mg OD- Lumark 500BD

25 Apr 2020 Tegral 200 mg BD- Citalopram alternate days 20 mg and 10 mg OD - Lumark 500BD

May June 2020 Dropped to 10 mg citalopram due to drug shortages.

Early July 2020: CT'ed citalopram - nonavailability of medicine. Tegral + Lumark remains same as before.

 

 

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  • 8 months later...

I definitely feel indifference as one of my major symptoms.  I track it as "anhedonia".  The feeling was strong in the beginning of my taper off venlafaxine, then subsided for awhile, then has become stronger as I get down into the very low doses.  I'm currently at 9.2 mg venlafaxine.  I'm a senior, age 73.  I have been doing the recommended slow 10% taper from the beginning.  

From reading other posts on this site, I will probably not get rid of this symptom until sometime after jumping off this drug.

5/1999 to 6/7/2002 Celexa (Citalopram) 30 mg  3 years 1 month.  6/7/2002 to 6/26/2002 switch from Celexa to Zoloft then wean off.  8/2014 start Venlafaxine 225 mg.

Other Pharmaceuticals per day:  Amlodipine 5 mg

Vitamins per day:  C 2,000 mg; D3 1.25 mg; Probiotic 218 mg; Fish Oil 1,600 mg; Magnesium Glycinate 240 mg; CoQ10 100 mg; Saw Palmetto 320 mg;

Start Taper: 225 mg to 55 mg; June 5, 2018 to June 15, 2019

55 mg (10%) June 15, 2019;  49 mg (10%) July 16, 2019; 44 mg (10%) August  13, 2019; 49 mg (up 11%) Aug. 26, 2019: 44 mg (10%) Sept. 10, 2019; 40 mg (10%) Oct. 8, 2019;  37.5 mg (6%) Nov. 6, 2019; 49.5 mg (up 32%) Nov 18, 2019; 44.5 mg (10%) Dec. 30, 2019; 40 mg Jan. 27, 2020; 36 mg Feb. 24, 2020; 32.5 mg March 23, 2020; 29.2 mg April 20, 2020; 26.3 mg May 18, 2020; 23.7 mg June 15, 2020; 21.3 mg July 6, 2020; 19.2 mg Aug. 4, 2020; 17.3 mg Sept. 1, 2020; 15.5 mg Sept. 29, 2020; 14.0 mg Oct. 27, 2020; 12.6 mg Nov. 24, 2020; 11.3 mg Dec. 15, 2020; 10.2 mg Jan. 5, 2021; 9.2 mg Feb. 2, 2021;

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