Are SSRIs numbing & blunting agents?

[MikePyle]

So SSRIs (Sertraline, Citalopram, Vortioxetine...) treat my base line anxiety quite well, also got rid of digestion problems, but I am struggling with emotional blunting, numbness, lack of motivation, indifference, no pleasure from anything or interest in engaging with anybody/anything. In an effort to avoid emotional numbness caused by Vortioxetine, I switched to Paroxetine thinking that this would possibly fix things since Paroxetine has slightly different effects than Vortioxetine but I feel the numbness coming back again. How do you get over this? Has anyone found a treatment or medication that is good for this? I'm not even getting enjoyment from food or exercise like I used to. Any ideas for augmentations to address this?

Thanks for any help/ anecdotes you guys can offer!

[panic_down_under]

I feel the numbness coming back again. How do you get over this? Has anyone found a treatment or medication that is good for this?

Welcome to No More Panic, Mike

Emotional blunting is a potential side-effect of all antidepressants, but not all will cause it for an individual. Given all the SSRIs you've tried have triggered it you may do better with a primarily noradrenaline, aka norepinephrine reuptake inhibiting SNRI - *milnacipran (Savella), *levomilnacipran (Fetzima), or TCA - nortriptyline (Pamelor), desipramine (Norpramin), lofepramine (Lomont). Another possibility is taking both sertraline and nortriptyline to create your own bespoke SNRI (while other SSRIs could be substituted, there are far fewer drug-drug interaction issues with sertraline).

* milnacipran and levomilnacipran are essentially the same med so it won't matter much which is chosen, but levomilnacipran is still in patent so may cost more

[MikePyle]

Welcome to No More Panic, Mike

thanks :=)

Emotional blunting is a potential side-effect of all antidepressants, but not all will cause it for an individual. Given all the SSRIs you've tried have triggered it you may do better with a primarily noradrenaline, aka norepinephrine reuptake inhibiting SNRI - *milnacipran (Savella), *levomilnacipran (Fetzima), or TCA - nortriptyline (Pamelor), desipramine (Norpramin), lofepramine (Lomont). Another possibility is taking both sertraline and nortriptyline to create your own bespoke SNRI (while other SSRIs could be substituted, there are far fewer drug-drug interaction issues with sertraline).

Choosing a different class might indeed help.
I will have a talk with my psychdoc.

[MikePyle]

What better alternatives are there to SSRIs?
Is Mirtazapine good?

[panic_down_under]

What better alternatives are there to SSRIs?
Is Mirtazapine good?

I'm not a fan. It seems to act mostly just as a sedative, not an antidepressant. The claimed serotonergic effects are dubious and unlike other antidepressants, there is no evidence it stimulates hippocampal neurogenesis. It is also the most poop-out prone med, often quitting within months. Weight-gain is a particular problem, more so than with other meds, due to the powerful carbohydrate cravings it induces in many.

That said, it may be worth a shot. It tends to worker much sooner than the others so you'll know fairly quickly whether it's a good med for you.

PS: forgot to ask, is therapy and option? The cognitive and/or behavioural (CBT, REBT, etc) and mindfulness therapies can be at least as effective as antidepressants.

[Chrysmar09]

What about people saying that ADs will change your personality or causes people to act out violently or recklessly? That has been a fear of mine that taking all of these ADs will change me. Im taking them to get back to who I was

[panic_down_under]

What about people saying that ADs will change your personality or causes people to act out violently or recklessly?

Apparently, Canadians rank among the biggest users of antidepressants. Do you see many people acting violently, or recklessly? Canadian murder rates (which are a good marker of violence generally) have been steadily declining since the early 1990s, about the same time SSRIs first became available, albeit with the occasional hiccup, just as they have in most developed countries, the opposite of what you'd expect if these meds were as dangerous as is being claimed. People taking psych drugs are much, much more likely to be victims of violence than its perpetrators.

[AntsyVee]

What about people saying that ADs will change your personality or causes people to act out violently or recklessly? That has been a fear of mine that taking all of these ADs will change me. Im taking them to get back to who I was

Chrys, c'mon. Your own doc told you that antidepressants don't do this. You already know this is just part of AD bashing. Many people would rather stay ill because that's the only thing they know. It's easier than taking the difficult steps to change.