Antidepressants May Blunt Feelings of Romance

Peter Forster Treatments of Depression

Antidepressants May Blunt Feelings of RomanceAntidepressants may blunt feelings of romance when taken long-term according to a recent study, but the way this effect shows up may be quite different in men and women.

Researchers presented a study at the European College of Neuropsychopharmacology (ECNP) Congress which used a newly developed Sex-Attachment-Love Test (SALT) questionnaire. They looked at almost 200 adults with mild or moderate depression and examined how treatment with either a serotonin antidepressant (SSRI) or a tricyclic antidepressant (TCA) affected feelings of love toward partners.

“The most striking finding was that men were more affected by emotional side effects than women,” lead author Donatella Marazziti, MD, professor of psychiatry at the University of Pisa, Italy, told Medscape Medical News.

They created a 40-item questionnaire specifically for this study. The questions were divided into three groups related to sexuality, attachment, and love.

The design of the study mirrored Helen Fisher’s theory that humans have three separate brain systems related to love and attachment –  one for sex, another for attachment and another for romantic love.

192 Italian outpatients (2/3rds of them women) with a diagnosis of mild or moderate depression, who had been taking just one antidepressant for at least 6 months, and were involved in “a loving relationship” participated in the study.

Most of the participants (76 women and 33 men) were taking an SSRI. The most commonly used was paroxetine (Paxil), followed by escitalopram (Lexapro), citalopram (Celexa) and sertraline (Zoloft). 48 women and 35 men were taking a TCA, with the most commonly used being clomipramine, followed by imipramine, and amitriptyline.

There was a significant “interaction effect of drug x gender” on the categories of love (P = .037) and sex (P = .007).

Women reported more impairment of sexuality with TCA’s. And men on SSRI’s reported more impairment of love.

“SSRIs seem to provoke more alterations of some emotional features than TCAs in men, while women seem to be ‘preserved’ by this side effect,”the investigators said.

When they looked at specific items on the questionnaire, the investigators found that, overall, patients taking SSRIs had significantly more “less than before” answers than those taking TCAs to several attachment statements, including the following: “I feel at ease in sharing with my partner thoughts and feelings”, “I address my partner for advice or help”, and “I rely on my partner easily”; and to the love statement, “I wish the love I feel for my partner would last forever”.

“In general, the patients felt less committed to and more detached from the partner than before the beginning of the treatment,” wrote the researchers.

Note, however, that this study was not a prospective study. It asked people who were already in treatment to rate how they felt now as compared with the past, and both mood and medications can affect recall. In other words, the study suggests that there may be an effect but is far from conclusive.

Moreover, it is hard to reconcile these findings with results from several studies examining the effects of SSRI’s on people without depression which consistently find that SSRI’s increase “pro-social” behaviors – and those studies have not just examined self reports but have looked at changes in behavior.

REFERENCES

27th European College of Neuropsychopharmacology (ECNP) Congress. Abstract P.2.e.001. Presented October 19, 2014.

Am J Psychiatry. 1998 Mar;155(3):373-9.

J Psychiatry Neurosci. 2014 Jan;39(1):60-5.

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