Antidepressants linked to major personality changes

[Louisiana1976]

Antidepressant medications taken by roughly 7% of American adults cause profound personality changes in many patients with depression, far beyond simply lifting the veil of sadness, a study has found.

Researchers saw strong drops in neuroticism and increases in extroversion in patients taking antidepressants, two of five traits thought to define personality and shape a person's day-to-day thoughts and behavior. The findings are striking, researchers said, because psychologists have long thought that such fundamental traits are moorings of an adult's personality that shift very little over a lifetime.

snip

http://www.latimes.com/news/nationworld/nation/la-sci-antidepressants8-2009dec08,0,433635.story

[Gman]

1. It could be that the medication allows those traits to come out

whereas they had previously been suppressed by the brain chemical imbalance.

[MannyGoldstein]

2. I'd Think The Change Towards Extroversion Would Be Expected

No?

[HuckleB]

4. Yup.

[mopinko]

3. iow- they work.

since personality change would be the goal.

[LeftishBrit]

5. Or perhaps being depressed makes you more neurotic and introverted...

and after treatment you become more your 'usual self'?

[salvorhardin]

7. IMHO 'self' is a rather fluid concept

I mean, if you think about it, our 40 year old selves can be much different from our 20 year old selves and our 20 year old selves are a lot different than our 10 year old selves. And why shouldn't they be? After all, our brains physically change every time we learn a new fact, have a new experience or learn a new skill. Also, look at what people often say when they end a long-term relationship/marriage... "He/she isn't the same person I first loved/married."

BTW: I think too that there's too much emphasis put on neuroticisms and introversion. While certainly both neurotic behavior and introversion can be profound enough as to negatively affect quality of life, but for the most part I think both are part of what makes us individuals. Of course, I say this as a neurotic, shy middle-aged male who makes Woody Allen look positively ebullient and well-adjusted.

[HuckleB]

8. +1

[LeftishBrit]

12. This is exactly what neuroticism and introversion/extraversion do mean in personality psychology...

just traits on which we all vary and which make us individual; not disorders. 'Neuroticism' is a slightly unfortunate term, as being high on this trait does not mean that one is actually suffering from a neurotic disorder, just that one is relatively inclined to anxiety and reactive to stress. People who are high in this trait are more likely to develop neurotic disorders than those who are low in this trait, but anyone can develop them. (This is all begging the question of how well the standard questionnaires do measure such traits.) Introverts and extraverts are equally likely to develop disorders, though they may be prone to different *types* of disorders.

Being in poor health, whether physical or psychiatric, is likely to make people more anxious and stressed, so that depression would be likely to make people higher in neuroticism, as well as trait neuroticism making people more vulnerable to depression. Also, though being introverted does not make you prone to depression, being depressed (or ill in any way) tends to make you less energetic and outgoing, so likely to score in an introverted direction in a personality test.

Studies of the relationships between personality and physical/mental health have tended to focus on possible influences of personality on health, so it is a good thing that studies like this one are now looking at the other direction of causation.

(Apologies if I sound a bit as though I'm giving a lecture; it is because I *do* have to give lectures on individual differences, and it looks as though next term's lectures will need to be updated a bit, in view of new evidence.)

[salvorhardin]

15. No worries

And I worded my post badly. I didn't mean to imply neuroticism as a personality trait implied neurotic disorder. I was actually referring to pop-psychological empahasis on neuroticism and introversion. It's one of my pet bugaboos -- the common idea that if one is introverted or neurotic (or both), then they are not mentally well adjusted.

BTW: I'm aware of a number of studies in the past decade that show personality isn't necessarily as fixed as Adler, et. al. believed. Is the repeated emphasis on personality as static just bad reporting or is this still the consensus view?

[LeftishBrit]

17. Stability of personality traits is a controversial issue...

Traditional personality theory tends to assume high stability of traits, and the proponents of some personality theories (e.g. Costa and McCrae with their 'Big Five' traits) tend to be rather dogmatic about how stable their traits are.

However, in the last few years there has been more emphasis on the potential changeability of traits. It is unusual for people to change totally, e.g. from being extreme extraverts to being extreme introverts or vice versa. However, there is a general tendency for both neuroticism and extraversion to decrease with age in adulthood; while conscientiousness tends to increase. Moreover, individuals who are studied longitudinally often show their own individual patterns of changes: sometimes as an obvious response to outside events; sometimes seemingly spontaneously. A paper of interest with regard to this subject is:

Roberts, B. W., & Mroczek, D. (2008). Personality trait change in adulthood. Current Directions in Psychological Science, 17, 31-35.

[HuckleB]

6. I'm not sure why the finding are so surprising.

How much hard science went into the psychologists (which psychologists, btw?) assumption that personality don't change via treatment? The findings are supportive of the efficacy of antidepressants, yet, the study covers one SSRI, and is only one study. Thus, this is one step in the scientific process. Nothing more, nothing less.

[groovedaddy]

9. In the Enneagram system of personality typing, there are 3 components

or variations of personality based on: 1. Who we are under normal circumstances, cruising along, so to speak. 2. Who we are when things are going just grand. 3. Who we are when we are stressed out, depressed, etc.

According to this system, these are all different personalities and it does happen that people get stuck in #3.

Basically, this is consistent with the findings of this study.

[truedelphi]

10. Good link and info. Thank you. n/t

[drm604]

11. Isn't that what they're supposed to do?

:shrug:

[Chemisse]

13. I don't see that as a surprise

Since social anxiety is one of the conditions that is helped by SSRIs. If relieved of social anxiety, one might be a whole lot more likely to be extroverted.

[hedgehog]

14. One problem with studies like these is that for any given SSRI, X%

of the people taking it will not respond. that's why so many depressives go through several drugs before ending up with one that works.


In other words, if only 1 SSRI is used in the study, X % of the people taking it will say it doesn't work. Half of those people may respond to a second SSRi, and the remainder to a third SSRI.

[salvorhardin]

16. I don't think that matters here

They looked only at patients taking Paxil and still found a significant (huge actually) change on both introversion and neuroticism scales versus placebo and they controlled for improvements in the patients' depression.

Results Patients who took paroxetine reported greater personality change than placebo patients, even after controlling for depression improvement (neuroticism, P < .001; extraversion, P = .002). The advantage of paroxetine over placebo in antidepressant efficacy was no longer significant after controlling for change in neuroticism (P = .46) or extraversion (P = .14). 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. Although placebo patients exhibited substantial depression improvement (Hamilton Rating Scale for Depression score, –1.2 SD, P < .001), they reported little change on neuroticism (–0.18 SD, P = .08) or extraversion (0.08 SD, P = .50). Cognitive therapy produced greater personality change than placebo (P ≤ .01); but its advantage on neuroticism was no longer significant after controlling for depression (P = .14). Neuroticism reduction during treatment predicted lower relapse rates among paroxetine responders (P = .003) but not among cognitive therapy responders (P = .86).

Conclusions Paroxetine appears to have a specific pharmacological effect on personality that is distinct from its effect on depression. If replicated, this pattern would disconfirm the state effect hypothesis and instead support the notion that SSRIs' effects on personality go beyond and perhaps contribute to their antidepressant effects.
http://archpsyc.ama-assn.org/cgi/content/abstract/66/12/1322

BTW: I've got to give props to the Melissa Healy at the LA Times for linking to the actual abstract of the study she was reporting on.