Posted by doxogenic boy on October 22, 2013, at 11:46:43
In reply to Re: Irving Kirsch, placebos and antidepressants » doxogenic boy, posted by SLS on October 22, 2013, at 11:30:29
Thanks for your reply.
Here is a case report which indicates that dose reduction can help for SSRI-induced apathy.
http://www.ncbi.nlm.nih.gov/pubmed/21240154
Psychopharmacol Bull. 2010;43(4):76-9.
Antidepressant induced apathy responsive to dose reduction.
Kodela S, Venkata PD.
SourceCarilion Clinic-Virginia Tech Psychiatry Residency Program, Roanoke, VA, USA. sreekant.kodela@googlemail.com
AbstractApathy has a significant negative impact on the quality of life. It can be a part of other axis I and axis III disorders such as depression. It has also been reported as a treatment emergent side effect of SSRI drugs. A 48 year old male with diagnosis of personality change due to medical condition and depressive symptoms was started on Sertraline. Although his depressive symptoms, impulse control and his irritability improved significantly he became quite apathetic. This responded positively to a reduction in the dose of sertraline. Since apathy can be a residual symptom of depression it may be a valid consideration to increase the dose of the SSRI. However if apathy was not a significant part of depressive syndrome prior to SSRI treatment then antidepressant treatment emergent apathy needs to be considered and one option is to reduce the dose of the SSRI. Other options appear to be addition of other pharmacological agents such as stimulants, dopamine agonists, acetylcholinesterase inhibitors and NMDA antagonists.
- doxogenic
Earlier TRD/anxiety
300 mg tianeptine, 6 X 50 mg successfully since Oct 2009
20 mcg liothyronine
40 mg escitalopram
100 mg trimipramine
50 mg agomelatine
600 mg quetiapine
poster:doxogenic boy
thread:1052457
URL: http://www.dr-bob.org/babble/20130930/msgs/1052775.html