Do Antidepressants Impair the Ability to Extinguish Fear?



Science Daily

June 10, 2013 — An interesting new report of animal research published in Biological Psychiatry suggests that common antidepressant medications may impair a form of learning that is important clinically.

Selective serotonin reuptake inhibitors, commonly called SSRIs, are a class of antidepressant widely used to treat depression, as well as a range of anxiety disorders, but the effects of these drugs on learning and memory are poorly understood.

In a previous study, Nesha Burghardt, then a graduate student at New York University, and her colleagues demonstrated that long-term SSRI treatment impairs fear conditioning in rats. As a follow-up, they have now tested the effects of antidepressant treatment on extinction learning in rats using auditory fear conditioning, a model of fear learning that involves the amygdala. The amygdala is a region of the brain vitally important for processing memory and emotion.

They found that long-term, but not short-term, SSRI treatment impairs extinction learning, which is the ability to learn that a conditioned stimulus no longer predicts an aversive event.

"This impairment may have important consequences clinically, since extinction-based exposure therapy is often used to treat anxiety disorders and antidepressants are often administered simultaneously," said Dr. Burghardt. "Based on our work, medication-induced impairments in extinction learning may actually disrupt the beneficial effects of exposure-therapy."

This finding is consistent with the results of several clinical studies showing that combined treatment can impede the benefits of exposure therapy or even natural resilience to the impact of traumatic stress at long-term follow-up.

The authors also suggest a mechanism for this effect on fear learning. They reported that the antidepressants decreased the levels of one of the subunits of the NMDA receptor (NR2B) in the amygdala. The NMDA receptor is critically involved in fear-related learning, so these reductions are believed to contribute to the observed effects.

Dr. John Krystal, Editor of Biological Psychiatry, commented, "We know that antidepressants play important roles in the treatment of depression and anxiety disorders. However, it is important to understand the limitations of these medications so that we can improve the effectiveness of the treatment for these disorders."

Journal Reference:

Nesha S. Burghardt, Torfi Sigurdsson, Jack M. Gorman, Bruce S. McEwen, Joseph E. LeDoux. Chronic Antidepressant Treatment Impairs the Acquisition of Fear Extinction. Biological Psychiatry, 2013; 73 (11): 1078 DOI: 10.1016/j.biopsych.2012.10.012

Source: http://www.sciencedaily.com/releases/2013/06/130610084140.htm

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Comments

This is why I say it is wrong to use antidepressants as anti-anxiety drugs...

Using it to cover up the depression in a toxic way creates more harm than good...
 
Very interesting post indeed. Another of the myraid of reasons ive never taken an ssri ever. Even all the times drs wanted to give it to me for anxiety, post wd, practically everything it seemed was treatable with an ssri or snri lol.
 
So in other words it keeps fear irrational and prevents you from learning your way out of it. No wonder the suicide rate increases with long-term SSRI use. They really don't understand how SSRIs work yet so many people are prescribed them.

From my own experience with the emotional numbing of SSRIs, I would say that it's hard to achieve true progress since your own intuitive guidance is disabled. Maybe they're better for short-term crisis intervention, but not long term therapy. I don't think it's healthy to be on SSRIs for years, and in my case I think it hindered certain areas of personal development.
 
I have often worried that, by taking drugs, I was stunting the growth that I might have experienced sober.
I have never taken an anti-depressant, but this makes sense to me.
Certain kinds of learning depend on dealing directly with various difficult situations.
Taking drugs might numb these, or make me feel so enlightened that I don't need to deal with these things, but either way I miss my chance to learn and grow.
 
Psychedelic Jay;11619833 said:
This is why I say it is wrong to use antidepressants as anti-anxiety drugs...

Using it to cover up the depression in a toxic way creates more harm than good...
I definitely agree.

SSRI's are a waste of time to begin with, but after seeing study after study that shows how awful they are, I think I'd almost rather be addicted to benzos, especially since they actually do something! Then have to take SSRI's long term.
 
SwampFox56;11621388 said:
I definitely agree.

SSRI's are a waste of time to begin with, but after seeing study after study that shows how awful they are, I think I'd almost rather be addicted to benzos, especially since they actually do something! Then have to take SSRI's long term.
The thing about SSRI’s is that there is no real way to tell if they are working or not without some kind of toxic reaction to them.

The emotional blunting is indeed a toxic reaction.

SSRI’s are definitely just as toxic if not more than the drugs we would use outside of a clinical setting.

This is why antidepressants are not justified for use to anyone in my honest opinion.

They serve no help immediately and create a fraudulent mind-space of security to people... And they do stop working like every other drug you can build tolerance to.

So why not go get high for the same price.

A lot of people just need to be helped and taught to take life one day at a time. That will help millions.
 
slimvictor;11621351 said:
I have often worried that, by taking drugs, I was stunting the growth that I might have experienced sober.
I have never taken an anti-depressant, but this makes sense to me.
Certain kinds of learning depend on dealing directly with various difficult situations.
Taking drugs might numb these, or make me feel so enlightened that I don't need to deal with these things, but either way I miss my chance to learn and grow.
Honestly, I would be less worried about my development if I had done psychedelics periodically as a teenager than being on SSRIs constantly. I think the latter has far more insidious effects. I've known a lot of people who took psychedelics occasionally as teenagers and they turned out fine.
 
^ maybe so, but it seemed like the "false wisdom" that psychedelics appeared to have brought me was a difficult thing to get past.
Not that I didn't gain any real experience, or wisdom.
But some of what I thought I had gained was actually just borrowed, if you can catch my meaning.
Then, I had to learn it slowly afterward.
And, more than psychedelics, cannabis probably stunted my emotional growth at times (though it may have helped at other times).
 
Never Knows Best;11620944 said:
Fascinating, thanks for posting this.

Since it's NMDAR mediated, might dissociative abuse cause this too?
At first glance, it seems like SSRIs cause incomplete NMDA receptors to be assembled. I guess that means they deactivate a certain gene or genes. NMDA antagonists don't do this, right? They just latch on to the receptor and prevent NMDA from binding. After they wear off, the receptors would still be there, right? Relevant part of the article:

he authors also suggest a mechanism for this effect on fear learning. They reported that the antidepressants decreased the levels of one of the subunits of the NMDA receptor (NR2B) in the amygdala. The NMDA receptor is critically involved in fear-related learning, so these reductions are believed to contribute to the observed effects.
 
I've experienced this first hand unfortunately :\

I was given, by a proper bitch of a psychiatrist, Mirtazapine (which is a NaSSA instead of just an SSRI, but practically the same goal and method) coupled with Buspirone.

The Buspirone or the Mirtazapine took away my fear of death and the other one brought a really bad case of suicidal ideation. Like crying down the phone to a friend that I didn't want to see tomorrow...
I feel so bad for putting her through that :(

So, yes, the fear of death is quashed and then the thoughts of killing myself swell up like a balloon.
Great combination, ay? :|
 
Indeed! So glad you're still with us Monsta :)

Imagine if a single dose of some future Psilocybin derivative brought weeks of relief. Big Pharma wouldn't make much money out of that, would they? If only people like British scientist & prohibition critic David Nutt were free to experiment with Psilocybin...

http://epetitions.direct.gov.uk/petitions/51485
 
I thank you Si Ingwe :)~<3

Exactly! There's already been both Psliocybin and MDMA based therapy - though "illegally" - and they've been extremely successful, so we need a massive glove to slap the politicians in the face to declare a duel to the death (and try knock some fucking sense into them :X) !
They will have a sword, but we will have rail and gatling guns ;)
 
John hopkins bayview campus here in bmore does research with psilocybin and its funded by nida, they are located on the bayview campus and routinely advertise for wanting participants in studies. Ive done 2 diff opiate studies and wanted to do the psilocybin one but didnt qualify, probably due to the fact i was in 2 prior trials. Really wanted to see what they do for that one and also what it actually looked like. There is a huge lab in the complex you can kinda see into, and im guessing thats where they process and or make/synth the drugs they give in trials.
 
I can see this because not long after starting Wellbutrin I started feeling like it would be so much easier to kill myself. I already wanted to but I feel like the medication kind of took away the natural barrier that exists in the human mind that stops you from crossing that line. the wellbutrin kinda took away that line and made it seem like it would just be as simple as taking the next step when youre walking. it made me seem like much less of a big deal and I didnt feel afraid of it at all.

That made me feel really peaceful and happy though and knowing it would be so easy made me feel better than i had in a while.
 
A couple of people have misunderstood what's being claimed here. It's not that SSRIs remove your fear of death. It's that they impair your ability to stop fearing. These are almost opposites.
 
Man, so much hate on pharmaceutical drugs on here. From reading what a lot of you guys are saying I'd swear we were talking about the efficacy of doctor prescribing cyanide for depression rather than SSRIs (and somehow I feel like there are at least a couple people here who would claim that taking antidepressants would somehow be worse than consuming cyanide). Don't get me wrong, I'm not saying I'm much of fan of a lot of psychiatric drugs either, and I feel like antidepressants get thrown around a whole lot despite the fact that they can have fairly significant side effects and have really only been proven to perform better than placebo in severely depressed patients, but c'mon you guys, I feel like we're going overboard here.

Oh, and as far as "fear learning" or w/e goes, I can say that personally, despite being on 40 mg of lexapro a day, I'm pretty darn terrified of dying. Hell, if anything the fact that I'm so afraid of the unknown (and thus death by extension) is one of the primary things so greatly hindering me in life right now, so idk, if anyone could give me some of this fearlessness they're describing I think it might rather do me some good...
 
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