December 07, 2009
Depression Drug Alters Personality

The selective serotonin reuptake inhibitors (SSRIs), drugs used to treat depression, make people less neurotic and more extraverted.

Individuals taking a medication to treat depression may experience changes in their personality separate from the alleviation of depressive symptoms, according to a report in the December issue of Archives of General Psychiatry, one of the JAMA/Archives journals.

Two personality traits, neuroticism and extraversion, have been related to depression risk, according to background information in the article. Individuals who are neurotic tend to experience negative emotions and emotional instability, whereas extraversion refers not only to socially outgoing behavior but also to dominance and a tendency to experience positive emotions. Both traits have been linked to the brain’s serotonin system, which is also targeted by the class of antidepressants known as selective serotonin reuptake inhibitors (SSRIs).

I wonder whether other SSRI drugs have the same effects on personality and also whether some SSRIs cause more or less personality change as compared to depression change.

This effect isn't simply due to lifting of depression. People whose depression improved as much without SSRI usage did not experience as much personality change.

All participants experienced improvement in their symptoms of depression. However, even after controlling for these improvements, individuals taking paroxetine experienced a significantly greater decrease in neuroticism and increase in extraversion than those receiving cognitive therapy or placebo. “Patients taking paroxetine reported 6.8 times as much change on neuroticism and 3.5 times as much change on extraversion as placebo patients matched for depression improvement,” the authors write.

The ability to change one's personality would be handy. Become less extroverted when you want to sit home and write a book. Become more conscientious if you are disappointed by your own performance. Change our level of agreeableness depending on whether you need to stand up to someone treating you unfairly or perhaps get along better with someone you needlessly argue with. Got any personality changes you want to make? What are they?

Share |      Randall Parker, 2009 December 07 11:33 PM  Brain Emotion Alteration


Comments
elitist said at December 8, 2009 6:40 AM:

Beginner's re (by now ancient) the controversy on biopsychiatry should visit http://www.cchrint.org/

speaking as an insider, I can't get people up to speed in 2 minutes, but basically SSRIs are designed to block the body's natural ability to process and excrete serotonin, and the body often compensates by refusing to make any more, hence the sudden and devastating black depressions and suicidal impulses so commonly associated with their use.

bio psychiatry is a fraud, and many neurologists and brain specialists are furious about it.

like alcoholism, and drug abuse generally, it is a baseball bat approach to adjusting brain chemistry.

if you want a serotonin boost eat a big plate of spaghetti.

if you want to be feel more relaxed and focused, try meditation and exercise.

every 10 years, a new generation of miraculous psychiatric medications arrive, the ones with "practically no side effects and almost universal effectivity."

then comes disillusionment, another generation of drugs, etc.

people taking Prozac style drugs are often also prescribed with up to 7 (!!!!) additional medications in order to treat the manifold side effects caused by the first drug:
(insomnia, impotence, hysteria, suicidal ideation, uncontrollable trembling...)

here's a fun trivia quiz for all of you aficionados of psychiatric medication out there:
of all the people who have snapped and gone "postal" over the last 20 years or so, how many were not treated chemically by psychiatrists first??

(answer: they all were....)

psychopharmacology is a billion-dollar industry, and when the truth comes out it will collapse overnight, and the tsunami of misinformation.

the farmer firms spend more on lobbying and advertising and publicity than the entire budgets of most first world countries.

fishbane said at December 8, 2009 8:37 AM:

of all the people who have snapped and gone "postal" over the last 20 years or so, how many were not treated chemically by psychiatrists first??

Talk about selection bias. This is like pointing out that diabetics have had blood tested by doctors.

[...] and when the truth comes out [...]

Ah. I see.

Lono said at December 8, 2009 8:49 AM:

elitist,

Although I AM a proponent of judicial recreational and experimental drug use - and I would like to see a time when people can alter their mood/personality at will to fit the situation - I would have to agree with pretty much everything you said above.

I am classically trained in Bio-Psychology and Cellular/Molecular Biology - as well as Computer Science - and I am certainly no stranger to the subject.

I have also witnessed the effects - first hand - of these SSRIs on friends and loved ones - and while some extraversion increased and some anxiety decreased - it was often at the expense of cognitive function.

And really - what Zombie doesn't like to go out there and mix it up with the public?

I also agree with the notion that almost all high profile shootings in the last decade have been committed by patients either currently or formerly under the influence of SSRIs or similar acting pharmecuticals - to me clearly some type of impulse control mechanism is weekened by their use in a patient.

Although one could argue that it is mere correlation with people who already have mental issues - I think (and I believe the facts will bear out) that it is more likely to be causative in many of these deadly criminal cases.

I don't agree that the psychopharmacology industry will collapse any time soon, however, for their specialty is manipulation - and the sheeple ever so love to be led to the slaughter.

(I am not against psychiatry as a whole - just what it has in many ways become)

random said at December 8, 2009 9:12 AM:

Speaking as someone with close family that has serious emotional issues, these drugs are horrible, but they're still better than the alternatives. No medication leaves them unable to function in society, and the only other treatment is ECT. It was my understanding that it electroshock treatments had gone out of style with lobotomies, but it is still used to treat severe depression, and the side effects are worse than any medication.


@elitist - For some people, therapy, exercising and eating right (including supplements of Omega-3 and Vitamin D), are simply not enough.

Joshua said at December 8, 2009 4:35 PM:

"The ability to change one's personality would be handy."

Isn't that what alcohol is for? And cannabis? And ecstasy? And cocaine?

Joshua said at December 8, 2009 4:37 PM:

"And really - what Zombie doesn't like to go out there and mix it up with the public?"

You're describing Ambien perfectly. That is some dangerous stuff...

conrolratx said at December 8, 2009 7:29 PM:

A plate of spaghetti? Are you fricking kidding? Nobody who actually works wtih the mentally ill would say such a ridiculous thing. Maybe that works for you normals when you are a wee bit down in the dumps. For real psych patients that's not gonna cut it.

I've been taking paroxetine (paxil) since 1993. Before it I was a horrible mother and I couldn't hold a full time job. I don't care if it knocked my IQ down a little bit. I don't care if it it had some side effects (for which I've never taken other meds). I care that my happy healthy daughter graduated from college in May 2009 and her little brother is well on his way. I care that I was able to send her to good private schools here in the bay area because my altered personality enabled me to work and make good money in the software industry. My taking paxil has been a net plus for society and my family.

You guys who are raging at the imperfection of these drugs are lucky that don't know what it's like to really need them.

Inverse Agonist said at December 8, 2009 8:47 PM:

elitist is off the reservation. And it's a shame because there are legitimate problems with the widely held monoamine hypothesis of depression, namely with the contribution (or lack thereof) that Serotonin casually gives. The causation of depression, which is important if you work in the field or want to engineer ones mood or personality, is undoubtedly not due just to a simple chemical imbalance and a lack of Serotonin if the cleft specifically. Note the lack of mood alteration in the majority of people after acute tryptophan depletion, which drastically lowers 5HT, or the effectiveness of Tianeptine, a SSR-enhancer.

Yet, none of this much matters if you are truly depressed as conrolratx said. You really don't care if its root cause is a problem with information processing on a network level, all you care about is that by altering your 5HT, due to some small overlap out in functional space, you can help your mood. And SSRI's and antipsychotics undoubtedly help.

The underlying difference, and fact that SSRIs treat the problem on a functional level, not on a physical level that is specific to the cause, does make a (huge) difference if you want to specifically play with ones mood/personality like Randall wants to. Which is why I posted.

RP said at December 9, 2009 2:30 AM:

here's a fun trivia quiz for all of you aficionados of psychiatric medication out there:
of all the people who have snapped and gone "postal" over the last 20 years or so, how many were not treated chemically by psychiatrists first??

Using your logic, how many people who died of heart disease in the past 20 years were not on medications prescribed by their cardiologist first? Idiot. Go back to reading L. Ron Hubbard.

Bob Badour said at December 10, 2009 10:44 AM:

I don't get depressed; although, I was on the cusp of it once. Here are some of my observations:

1. For at least a half hour after I wake, parts of my brain remain asleep. People who awake all chipper and animated just annoy me. "Start your day in a positive way" is basically meaningless. "Start" is a particularly uninformative verb.

2. I agree that "more and better sleep" is almost universally good advice. Unless you are going to define what "balance" means and tailor it to each individual's metabolism, "eat in a balanced way" is uninformative. I would amend your exercise recommendation to "engage in some purposeful exertion as often as possible and for as long as necessary." Cooking or knitting are purposeful, but do not exert. Running on a treadmill or lifting weights exert but without purpose do not engage the mind leaving it to mull over all things bad.

3. Again, "start" is a particularly uninformative verb. What builds self-esteem? How does one build it?

4. "Learn to manage" is not only uninformative but counter-productive. It imposes a moral judgment on those dealing with stress without offering any actionable advice. If stress is a problem, it's no longer the stress but their ignorance or their failure to manage it. Sure, some people make things worse than necessary, but that's not always the case. In 2006 when I was on the cusp of depression, I took some online stress quizzes. In one of them, the stressors in my life had hovered just below the median tolerable limit of 250 until my dog got sick, which shot me 60 or so points over the median limit. Looking at the advice of "avoiding avoidable stressors", I found at most I could knock 15 points off--still leaving me 45 points over the median limit. And "avoiding avoidable stressors" is actually informative and actionable.

5. Family doctors are mostly ignorant about depression and anything neurological. They really only know what the pharmaceutical salesmen want them to know. When I described my autistic inertia to my family doctor, she put me on an anti-depressant with disastrous results; even though, I made it clear I did not meet the diagnostic criteria for depression--I had joy in my life every day. Instead of sending people to family doctors, I suggest you send them to a psychologist or counselor, who cannot prescribe, and then let the psychologist refer to a psychiatrist if necessary. It's a problem when all 40 million of the 32 million depressed people are diagnosed with depression.

That said, I recommend people read up about stress. Acute stress and chronic stress. So they can know how bodies respond to stressors and can learn where they are in the progression from chronic stress to anhedonia. e.g. What happens when serotonin gets depleted? What happens when dopamine production drops off? How does one feel? etc.

Lono said at December 10, 2009 10:50 AM:

random and conrolratx,

Although I cannot speak for elitist - I certainly don't believe in prohibiting pharmacological intervention for extreme cases of depression and/or mental illness - clearly in some serious cases it will certainly be worth the trade offs and lead to a better standard of living.

I think, however, that like elitist suggests it is a way too heavy handed approach to dealing with more common forms of depression, anxiety, or stress managemnet - and it is bad science to just continue overprescribing these medicines simply because their is a huge financial conflict of interest in which to do so - when more "holistic" or common sense strategies (such as improved exercis/diet/time management) should be employed first for best results.

(and I am glad that Paxil has helped you conrolratx, but I am surprised if you make a living as a software coder/engineer - as my wife - a remarkeably talented and intelligent woman - could barely order a sandwich under prolonged, carefully prescribed, dosages of that particular anti-depressent)


Inverse Agonist,

I would disagree with your criticism of elitist - I think you and elitist both recognize the limitations of the monoamine hypothesis, and the imprecise, overkill, approach of just pumping up Serotonin levels in the brain.

Couple this with the fact that the brain reacts by reducing it's sensitivity to Serotonin and you have a potnetial recipe for disaster over the long haul.

I think you and I (and possibly elitist) can agree that with greater research, and less dogma, ways to alter the brain at the physcial level - more precisely than with simple chemical doping - will lead to long term solutions - followed by the potential for custom engineering - of one's base personality.

In the meantime, though, I think both Randall and I would be interested in short term pharmacological assistance - unless such assitance would lead to further long term imbalances in the brains neurotransmitter regulation - which at our current level of treatment it most certainlly could.

Thus, for genrealized improvements in mood and thinking, excercise, diet, and sunlight exposure are most likely to have the greatest long-term affects with little side issues.

Steve said at December 11, 2009 1:33 PM:

Also recall that the studies on Omega-3s that showed it to be effective against depression involved very high doses of DHA specifically (~3g/day). This is about 25 of your typical drugstore "Fish Oil" pill, which contains about 120 mg of DHA and 180 mg of EPA. So it's no surprise that people go to Walgreens, pop a few, and notice nothing. To get that sort of DHA dosage going you need a supplement containing only or mostly DHA, and you'll need to take quite a few.

Tj Green said at December 11, 2009 3:02 PM:

I like the idea of the "sleeptracker" watch as I believe depression is a sleep disorder.

controlratx said at December 12, 2009 3:46 PM:

Lono said: (and I am glad that Paxil has helped you conrolratx, but I am surprised if you make a living as a software coder/engineer - as my wife - a remarkeably talented and intelligent woman - could barely order a sandwich under prolonged, carefully prescribed, dosages of that particular anti-depressent)

I couldn't code full time on it. It dulls me down too much. So I became a technical writer. Good money if you can do the highly technical stuff and write code for examples and tutorials. Had some good luck with stock from a startup I worked at. Sold all my stock in Dec 2000. Cha-ching! But I would have cleaned toilets if I had to in exchange for the improvement to my parenting.

Lono said at December 16, 2009 8:58 AM:

controlratx,

Thank you for the clarrification - that is excellent you found a way to continue in the field in a lucrative manner.

I am glad SSRI use has had such a positive impact in your standard of living!

I do indeed hope that in the future we will have ways to effectively - and safely - alter our behavior for as long as needed to acomplish certain goals - but I do fear that simple greed and politics are greatly hampering the scientific research in this area.

Behavioral enginneering does have some real philisophical ramifications I believe - since we cannot be sure our altered self will share the same values/goals/motivation that our previous self did.

I have experimented with psychedelics informally in my past and learned that I absolutely have different interests and goals when under their influence.

I sometimes wonder if all long lived intelligent civilizations reach a kind of crisis point where form and mind manipulation has become so simple - that their own original identity as a species has become largely irrelevant - and only of nostalgic value.

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