Robert F. Kennedy Jr. wants to rein in antidepressants

WASHINGTON—At a mental health summit earlier this week, Health and Human Services Secretary Robert F. Kennedy Jr. announced that his department would begin urging doctors across the United States to prescribe fewer antidepressants to patients. According to Kennedy, HHS will push doctors to better inform patients about the risks of antidepressants, equip them to help patients get off the drugs, and encourage them to pursue other, nonmedicinal ways of addressing mental health problems.

Kennedy’s announcement comes as millions of Americans every day use psychiatric drugs that are often marketed as safe and effective, many of whom are taking the drugs without also pursuing other forms of mental health treatment, such as talk therapy. His announcement also comes after research published earlier this year showed that roughly 48% of Americans oppose government restrictions on the use of psychiatric meds.

“The United States does not just face a mental health crisis; we face a dependency crisis, driven by overmedicalization,” Kennedy said Monday during a keynote address at the Mental Health and Overmedicalization Summit in Washington, D.C.’s Willard InterContinental hotel. “Too many patients begin treatment without a clear understanding of the risks and how long they will stay on these drugs or how to come off of them.”

The summit was hosted by the MAHA Institute, which derives its name from the slogan “Make America Healthy Again”—a riff on President Donald Trump’s campaign slogan of “Make America Great Again.” The think tank claims to focus on helping Americans get healthy by working to end corporations’ control of American health policy.

Kennedy cited statistics showing that 1 in 6 American adults is on an antidepressant and nearly 1 in 10 children has a prescription for medication due to mental health needs. He argues that, while antidepressant medications such as selective serotonin reuptake inhibitors, or SSRIs, can be helpful tools, they shouldn’t be the default response to patients struggling with mental health issues. If doctors do prescribe them, patients need to be informed of the drugs’ risks and know how they can get off them, he said Monday.

Many advocates support Kennedy’s efforts to curb the overprescription of psychological meds such as antidepressants. They argue the drugs have harmed many people whose doctors never properly explained the drugs’ potential negative effects or the withdrawal symptoms patients could experience trying to get off the drugs. But some organizations caution against considering antidepressants as entirely harmful, insisting that many Americans benefit from them.

“I was prescribed an SSRI—Prozac, or fluoxetine—when I was 26 years old for, essentially, situational depression,” Morgan Stewart told me at the summit. Stewart later founded the Antidepressant Coalition for Education, which informs the public about the risks and long-term effects of antidepressants and supports individuals trying to wean themselves off them. “I had a sick family member. It was just kind of like a tough time. And I was given an SSRI for that,” she said.

Stewart said her doctors never checked in later to see how she was doing and whether she still needed to be on Prozac after that season of her life passed. “And so I just stayed on it for nine years,” she said. “I met my husband, I got married, I had children. And so life looked very different. And I just kind of had an intuition, I guess, that I just no longer needed the medication.”

In 2022, at age 35, Stewart chose to get off Prozac. The symptoms she experienced were “otherworldly,” she said. “They’re psychedelic in nature. In fact, some of us do hallucinate and go into psychosis,” Stewart explained.

First she struggled with insomnia. She also had twitches running up and down her body—a sign, she thought, of some sort of neurological injury or irritation.

“I had violent intrusive thoughts that I had never had before—prior to the medication [or] on the medication—of harming myself, harming other people,” Stewart said. “They were very bizarre. … I admitted myself to a psychiatric hospital during that time because it’s really jarring to suddenly have thoughts of hurting people, violent thoughts that you’ve never had before.”

Years later, the psychological struggles have subsided, but Stewart said she still struggles with some symptoms—sleep problems and “24/7 tinnitus”—she credits to that withdrawal from Prozac.

But some organizations, while applauding Kennedy’s focus on addressing mental health, caution that the Trump administration’s approach disregards the benefits of antidepressants for many users.

“There are many people for whom medications are important and lifesaving, and patients should not take themselves off medication without first consulting their physician,” the American Psychiatric Association said in a statement responding to Kennedy’s remarks.

The association acknowledged problems with the U.S. mental health system but argued they typically don’t stem from overmedicalization or overprescription but a lack of resources. “The solution is not to stigmatize psychiatric medication or impose broad assumptions on clinical care, but to ensure that patients have access to the full range of evidence-based treatments and that decisions are guided by the best available science and each patient’s needs,” the APA said.

The medical consensus on SSRIs remains mixed, according to The Lancet, one of the world’s oldest and highest regarded peer-reviewed medical journals. While some research has indicated SSRIs consistently outperform placebo pills across dozens of medical studies, other research has suggested that the drugs only marginally outperform placebos. In 2004, the Food and Drug Administration put a black box warning on SSRIs, saying that they had been known to increase the risk of suicide in young adults. Many in the medical community have criticized the warning.

Anders Sørensen, a Danish psychologist who spoke at the MAHA Institute summit on Monday, explained that withdrawal from antidepressants is a poorly researched and poorly understood subject. Most studies about antidepressant withdrawal feature patients who only took the drugs for a few months before getting off them. But for patients who’ve been on the drugs for years, stopping medication can be a harrowing experience. Their extreme withdrawal symptoms can make many physicians believe their underlying symptoms are returning after being suppressed by the drugs for so long.

“If you alter brain chemistry for long enough, the body adapts—not overnight, but gradually over weeks and years and months. And the longer that adaptation has been building, the more sensitive it becomes to change and the harder it gets to come off the medication. In many cases, that can mean tapering over years,” Sørensen said. “Because when you then remove the drug or reduce the dose too quickly, the system is thrown out of balance.”

Mark Horowitz, an associate professor of psychiatry at King’s College London, didn’t learn about tapering off psychiatric medications in school. He learned it by going through the process himself. He said that many psychologists, like him, don’t learn how to get their patients off psychiatric medications, leading to disaster when they try.

“The way we currently stop these drugs is biologically mismatched to how they work,” he said. He explained that because of how antidepressants interact with receptors in the brain, the more milligrams of a drug that a patient is prescribed, the less powerful of an effect the added drug will have. Proportionally, you get diminishing returns.

That relationship applies to tapering off the drug, too, Horowitz said. Often, doctors will tell patients trying to get off SSRIs that they need to reduce their dosage in a straight line—drop from 20 milligrams to 15 milligrams, and then to 10 milligrams, and then to 5 milligrams, for example. But doing so is bound to end badly, Horowitz said.

“If you look at the effect on the brain, the first reduction from 20 to 15 is a tiny little reduction of 3%. Next reduction, twice as large, twice as large again,” Horowitz said. “Going from 5 milligrams to zero milligrams is over a 50% change. So what looks like a gentle taper actually involves jumping off a cliff at the end.”

Stewart from the Antidepressant Coalition for Education said that if Americans knew the potential risks of getting on SSRIs, staying on them, and then trying to get off them, most of them would probably never get on the medications in the first place.

But panelists who spoke before the summit audience on Monday explained that many Americans who receive prescriptions for psychiatric meds aren’t given an honest assessment of the drugs’ risks before they receive their prescriptions. And often, their doctors don’t talk with them about an exit strategy for when—if ever—they’ll quit taking the drug.

The Health and Human Services department’s policy shift on antidepressants would work to change that. Federal health agencies plan to push doctors to provide more information to patients about the risks of SSRIs and to educate doctors about how to treat patients experiencing withdrawal symptoms like Stewart’s.

During his speech Monday, Kennedy said he has personally experienced heroin withdrawal symptoms. But he said the experience was nothing compared to what others experience when withdrawing from SSRIs.

“I went through cold turkey withdrawal probably over a hundred times. And so I know what it’s like. And it’s not fun. But it is limited. It’s finite in time. After 72 hours, it’s over. You just have to steel yourself for 72 bad hours,” Kennedy said. “I’ve watched people come off of SSRIs, and it is not even comparable.”

Kennedy described a family member who was suicidal while coming off of SSRIs. “She woke up every morning and said, ‘I don’t want to live,” he said. “And I’ve heard that from hundreds and hundreds of people. The same story again and again.”

Morgan Stewart explained that, aside from any government action, Americans’ awareness about the potential risks of SSRIs will be the biggest catalyst for change.

“I think the vast majority of antidepressant users are put on medications for—similar to my situation—just circumstances, you know? A divorce, a sick family member, work stress, school stress, whatever,” Stewart said. “But I think, if they knew how serious withdrawal could be, and they could make an accurate, informed risk-benefit assessment, I think they would opt out.”