EpistemisAffective flattening
Specialty: Psychiatry.
Why it occurs
- Schizophrenia (primary negative symptom)
- Major depressive disorder with melancholic features
- Chronic post-traumatic stress disorder
- Side effect of antipsychotics or high doses of SSRIs (antidepressant-induced apathy syndrome)
- Frontotemporal dementia (behavioral variant)
- Schizoid personality disorder
Initial workup
PANSS scale (negative subscale); neuropsychological assessment of theory of mind and facial emotion recognition; Quantitative brain MRI; serum levels of psychotropic drugs.
red flags
Total inability to respond emotionally to family emergencies, associated with serious personal neglect, malnutrition due to lack of interest in survival, or risks of abuse by third parties due to emotional passivity.
Standard management
- Cariprazine — atypical antipsychotic with preferential affinity for D3 receptors, effective in the affective flattening of schizophrenia
- Aripiprazole — dopaminergic modulator
- Reduction in the dose of serotonergic antidepressants or rotation to Bupropion if the symptom is secondary to drugs.
Educational guidance for study. It is NOT a prescription recommendation. The actual choice depends on the cause, the patient, and current guidelines.
- Area
- Psychiatry
- Listed causes
- 6
- Treatment options
- 3