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KMID : 1007420110090030149
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Mood and Emotion
2011 Volume.9 No. 3 p.149 ~ p.153
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Selective Serotonin Reuptake Inhibitor-Induced Apathy
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Song Hoo-Rim
Woo Young-Sup
Bahk Won-Myong
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Abstract
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Apathy is a syndrome of decreased motivation. It is a common problem observed in many neuropsychiatric disorders and considered as a dysfunction of the frontal-subcortical system (motivational circuit). Apathy also has been recognized in the treatment with selective serotonin reuptake inhibitor (SSRI). It is explained that excessive serotonin inhibit frontal function directly and indirectly. Apathy which is misdiagnosed to depression can be worsen by starting or increasing SSRI. So clinicians should know about the sign of apathy and pay attention to its development by routine monitoring and education to patients and their families before prescribing SSRI. The use of apathy scales such as the Apathy Evaluation Scale (AES) and the Apathy Scale (AS) will be helpful. SSRI-induced apathy is characterized by an insidious onset, dose-dependent effects and complete resolution of symptom with proper management. Treatment strategies include a dose reduction of causative SSRI, augmentation with a second drug which can improve apathy (ex, bupropion, olanzapine), or switching from SSRI to non-SSRI [ex, bupropion, serotonin-norepinephrine reuptake inhibitor (SNRI), tricyclic antidepressant (TCA)]. Given the prevalence of SSRI prescription, there should be more attention to SSRI-induced apathy and more objective data from well-controlled studies are required.
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KEYWORD
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Selective serotonin reuptake inhibitor, Apathy
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