The effects of venlafaxine, bupropion, or escitalopram on emotional blunting are minimal among patients with major depressive disorder (MDD), according to study results of a study published in Journal of Affective Disorders.
Researchers sourced data for the analysis from 3 randomized, double-blind, placebo- and active-controlled trials. Patients (63.1%-68.2% women; mean age, 36.7-43.8 years) with acute MDD were randomly assigned to receive 8 weeks of either venlafaxine (n=378), bupropion (n=389), or placebo (n=383) in trials 1 and 2, and escitalopram (n=254) or bupropion (n=260) in trial 3. The effect of treatment on emotional blunting was evaluated using the Montgomery-Åsberg Depression Rating Scale (MADRS) instrument.
At baseline, MADRS scores were between 29.6 and 30.5 points. The change in emotional blunting scores from baseline were lower among patients who received venlafaxine (mean difference [MD], -1.85; P =.02) and bupropion (MD, -1.82; P =.05) compared with placebo (MD, -1.61). A similar proportion of patients in each group experienced an increase in emotional blunting scores at follow-up (range, 4.88%-6.01%).
No differences in the change in emotional blunting scores were observed between bupropion and venlafaxine (t, -0.32; P =.75) or bupropion and escitalopram (MD, -1.83 vs -2.04; P =.08). Similarly, no differences in the proportion of patients with increased scores were observed.
The change in emotional blunting scores corelated with the change in depression symptoms, mood, suicidal ideation, illness severity, and sexual function (all P <.0001).
The major limitation of the analysis is that patients received treatment for 8 weeks, which may not have be long enough to observe an effect.
Study authors concluded, “The study medications did not appear to significantly blunt emotional responsiveness, nor was there any evidence to suggest that emotional blunting mediated treatment response. On the contrary, venlafaxine and bupropion seemed to increase emotional responsiveness relative to placebo, which was associated with clinical improvements more broadly.”
Disclosure: Multiple authors declared affiliations with industry. Please refer to the original article for a full list of disclosures.
Peters EM, Balbuena L, Lodhi RJ. Emotional blunting with bupropion and serotonin reuptake inhibitors in 3 randomized controlled trials for acute major depressive disorder. J Affect Disord. 2022;318:29-32. doi:10.1016/j.jad.2022.08.066