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Emotional Blunting During Antidepressant Treatment: Implications for Clinical Decision-Making and Patient-Centred Care.

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Τίτλος: Emotional Blunting During Antidepressant Treatment: Implications for Clinical Decision-Making and Patient-Centred Care.
Συγγραφείς: De Las Cuevas C; Department of Internal Medicine, Dermatology and Psychiatry, University of La Laguna, Tenerife, Spain.
Πηγή: Journal of evaluation in clinical practice [J Eval Clin Pract] 2026 Oct; Vol. 32 (7), pp. e70604.
Τύπος έκδοσης: Journal Article; Review
Γλώσσα: English
Στοιχεία περιοδικού: Publisher: Wiley-Blackwell Country of Publication: England NLM ID: 9609066 Publication Model: Print Cited Medium: Internet ISSN: 1365-2753 (Electronic) Linking ISSN: 13561294 NLM ISO Abbreviation: J Eval Clin Pract Subsets: MEDLINE
Imprint Name(s): Original Publication: Oxford, England : Wiley-Blackwell, c1995-
Ιατρικοί όροι (MeSH): Antidepressive Agents*/adverse effects , Antidepressive Agents*/therapeutic use , Antidepressive Agents*/administration & dosage , Emotions*/drug effects , Depression*/drug therapy , Depression*/psychology , Patient-Centered Care* , Clinical Decision-Making*, Humans ; Decision Making, Shared ; Patient Reported Outcome Measures
Περίληψη: Rationale: Emotional blunting is frequently reported during antidepressant treatment but remains conceptually underdefined. Reduced emotional reactivity and affective intensity may represent therapeutic benefit, an adverse effect, residual depressive symptomatology, or a context-dependent combination of these possibilities.
Aims and Objectives: To clarify the phenomenology and clinical significance of antidepressant-associated emotional blunting, distinguish it from residual depression, anhedonia, and apathy, and consider its implications for long-term prescribing, shared decision-making, and patient-centred care.
Method: Evidence from phenomenological and qualitative accounts, survey-based and clinical studies, neurobiological research, patient-reported outcome literature, and relevant ethical and clinical guidance was narratively integrated to examine the prevalence, mechanisms, subjective meanings, and management of emotional blunting.
Results: Emotional blunting is reported by a substantial proportion of antidepressant-treated patients, although estimates vary because of differences in definitions, instruments, populations, and study designs. Evidence suggests that serotonergic antidepressants may dampen the processing of both rewarding and aversive stimuli, but medication effects cannot always be clearly separated from residual illness. Patients' appraisals are heterogeneous: emotional attenuation may be experienced as protective or acceptable during acute treatment yet burdensome, alienating, or inconsistent with personal recovery during maintenance treatment. Misclassification may lead to inappropriate dose escalation, unnecessary continuation, or premature discontinuation. Clinical responses should therefore be individualised and may include maintaining treatment, dose reduction, switching, psychological or psychosocial interventions, or planned discontinuation.
Conclusion: Emotional blunting is best understood as a therapeutically ambivalent, patient-reported outcome whose significance varies with illness phase, treatment goals, perceived benefits, and individual values. Systematic enquiry and shared decision-making can support more clinically appropriate and person-centred antidepressant care.
(© 2026 The Author(s). Journal of Evaluation in Clinical Practice published by John Wiley & Sons Ltd.)
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Contributed Indexing: Keywords: antidepressants; emotional blunting; long‐term treatment; patient‐reported outcomes; shared decision‐making
Substance Nomenclature: 0 (Antidepressive Agents)
Entry Date(s): Date Created: 20261006 Date Completed: 20261006 Latest Revision: 20261008
Update Code: 20261008
PubMed Central ID: PMC13641087
DOI: 10.1111/jep.70604
PMID: 42836825
Βάση Δεδομένων: MEDLINE
Περιγραφή
ISSN:1365-2753
DOI:10.1111/jep.70604