Can antidepressant use be associated with emotional blunting in a subset of patients with depression? A scoping review of available literature

INTRODUCTION

Despite frequent recognition of emotional blunting in the published literature, either as a primary symptom of depression or as an adverse effect of antidepressants, there is no systematic synthesis on this topic to our knowledge. We undertook this scoping review to assess the prevalence, clinical features, implicated causes and management of emotional blunting, outlining the phenomenological and clinical gaps in research.

METHOD

A systematic search was done until March 15, 2022, to include all original studies (i.e., interventional trials, cohort & cross-sectional studies, case reports, and case series). All reviewed data were delineated to answer pertinent clinical, phenomenological, and management questions related to the phenomenon of emotional blunting.

RESULTS

A total of 25 original studies were included in our scoping review. Emotional blunting was described as a persistent diminution in both positive and negative feelings in depressed patients, who could subjectively differentiate it from their acute symptoms. However, the literature lacked the distinction between emotional blunting as a primary symptom of depression or an adverse effect of antidepressants. Common clinical strategies to manage antidepressant-induced emotional blunting included dose reduction or switching to a different antidepressant.

CONCLUSION

Emotional blunting was a significant patient-reported concern with antidepressants. Future research should clarify phenomenological and neurobiological constructs underlying emotional blunting to improve diagnostic and management skills.

Comparison of Uterine Artery Dynamics in Normotensive and Hypertensive Pregnancies on Doppler Ultrasound

Background: Hypertension during pregnancy is a common disease that can alter the health of both mothers and fetus. It is a leading cause of maternal, fetal, and neonatal death, as well as an increased risk of having an undesirable pregnancy outcome. Objective: To compare uterine artery dynamics in normotensive and gestational hypertensive pregnancies on Doppler ultrasound. Methodology: A cross-sectional case control study was carried out in Radiology department of District Head Quarter (DHQ) hospital, Faisalabad. Written consent was taken from all patients before the ultrasound examination. The calculated sample size was 98. Patients were assessed for eligibility in inclusion criteria. Confirmation of intrauterine living pregnancy and gestational age was done with routine obstetric ultrasound. Enrolled pregnant patients both normal and hypertensive were assessed for uterine artery Doppler ultrasound examination. Results: Ninety eight women, forty-nine with hypertension and forty-nine normal women participated in the investigation. The comparison of data showed that pre pregnancy weight and mean blood pressure were significantly high in hypertensive group when compared to the normotensive group (P <0.05). Doppler ultrasound also showed that the values of uterine artery parameters such as S/D Ratio, PI, RI was significantly high in hypertensive group when compared to the normotensive group (P <0.05). Conclusion: The Uterine artery Doppler parameters are significantly higher in hypertensive patients as compared to normotensive patients. According to the findings of our study, notching on the right, left, or bilateral, as well as Pulsatility index and Resistivity Index, are diagnostic parameters for evaluating the complications before they worsen. Keywords: Uterine artery, Gestational hypertension, Doppler Ultrasound, Doppler Indices, Pre-Eclampsia