SSRIs Impair Learning From Negative Feedback


A study comparing the effects on cognition of major depression (MDD) vs. SSRIs finds that healthy subjects learn significantly better from positive feedback than either medication-naïve or medicated MDD groups. “In contrast,” says the study’s abstract, “medicated patients with MDD learned significantly less from negative feedback than both medication-naïve patients with MDD and healthy subjects, whose learning accuracy was comparable… However, medicated MDD and HC profiles are not similar, which indicates that the state of medicated MDD is not ‘normal’ when compared to HC, but rather balanced with less learning from both positive and negative feedback.”

Abstract →

Herzallah, M., Moustafa, A., Natsheh, J., Abdellatif, S., Taha, M., et al: Learning from Negative Feedback in Patients with Major Depressive Disorder is Attenuated by SSRI Antidepressants. Frontiers in Integrative Neuroscience. doi: 10.3389/fnint.2013.00067

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Kermit Cole
Kermit Cole, MFT, founding editor of Mad in America, works in Santa Fe, New Mexico as a couples and family therapist. Inspired by Open Dialogue, he works as part of a team and consults with couples and families that have members identified as patients. His work in residential treatment — largely with severely traumatized and/or "psychotic" clients — led to an appreciation of the power and beauty of systemic philosophy and practice, as the alternative to the prevailing focus on individual pathology. A former film-maker, he has undergraduate and master's degrees in psychology from Harvard University, as well as an MFT degree from the Council for Relationships in Philadelphia. He is a doctoral candidate with the Taos Institute and the Free University of Brussels. You can reach him at [email protected].


  1. This makes sense to me, based on what people have reported to me and in the literature about the numbing effects of SSRIs. It appears to make a person less sensitive to any input from the environment, positive or negative. This may seem like a relief if you’re chronically anxious (as now you no longer care what Aunt Mable thinks of your new dress), but it also may mean failing to care about the consequences of your actions (So, I’m breaking the law – big deal). I think this is where a lot of the increased suicide/violence/homicide comes in – people may have had an impulse in this direction before, but would never have considered acting on it, because the consequences were too serious. But with SSRIs, the consequences have much less significance, so killing someone else or oneself doesn’t seem so bad any more.

    —- Steve

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    • That also could include, I imagine, abuse on the consumer of SSRI. The abuse would be negative feedback on the revictimized comsumer of SSRI and would prevent, at least in part, leaving an abusive relationship, even if it is just with the therapist, the psychiatrist,the partner or another provider of SSRIs, etc..

      Like a trifecta in some cases.

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