R.F.K. Jr.’s Newest Mission: Getting Us Off Antidepressants

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In his latest public health crusade, Robert F. Kennedy Jr., is asking why millions of Americans have been taking psychiatric drugs for far longer than ever intended. I have been on the lock since I was eight years old. I've continuously been on any threat since 27 years. I've been on Lovox 30 years. I've been on them longer than I've not been on them.

In the process, he's highlighting an open secret in medicine. The doctors are much better at starting drug treatments than at stopping them.

I was told to take it daily, and I never questioned that.

I don't really think I even asked or thought about how long I would be on it. I did not know that I was thinking of having for the rest of my life, and that patients who want to end their treatment are increasingly taking matters into their own hands.

“All of a sudden, I felt so strongly that my brain was like, "You need to get off this medication."”

Today, Ellen Barry takes us inside the growing movement to deep prescribe. It's Monday, June 22nd. Ellen, nice to have you on the show. Thank you for having me. Let me just start by asking how you came to this topic of deep prescribing,

and for the uninitiated, can you just define that phrase? Deep prescribing is the art and science of carefully tapering off a psychiatric medication, or reducing a psychiatric medication.

I first heard the term, really, from patient groups.

There has long been a subculture of people who talk to each other on the internet

“about being harmed by medication or feeling that their medication isn't working anymore,”

who sort of compare notes on how to get off them. And those communities, that's nothing new. They've been out there for decades, really, since the early days of social media. But what's new is that this group, largely of patients, now has a seat at the table, as federal health policy is developed.

And that's because of RFK Jr. I want to say, President Trump, for her entrusting me to deliver on his promise to make America healthy again. Dr. Kennedy made it clear during his confirmation hearings that one of the things he was looking at would be curbing the use of psychiatric medications in the US.

If the impression of American youth are now on at a wall or some other ADHD medication, he talks specifically about anti-depressants in those hearings that these medications were sort of dependents forming that we prescribe them to freely. Even higher percentages are on SSRIs and benzos. We are not just of Medicaid, our children were over-medicating our child population.

And what he was talking about was the most widely used category of psychiatric medications, SSRIs. Listen, I know people including members of my family who've had much worse time getting off of SSRIs than people who have getting off of heroin. He said that SSRI anti-depressants are harder to quit than heroin.

Huh, is that true? No, there's no evidence supporting that.

SSRIs are used by probably around 35 million American adults.

These are selective serotonin reuptake inhibitors like Prozac or Zolafte or Lexapro. They're considered so safe to prescribe that overwhelmingly they're prescribed by family doctors or GPs rather than psychiatrists. And they're used for sort of an ever expanding array of different problems, not just for depression, but also for all kinds of anxiety disorders, obsessive compulsive disorder, social anxiety,

Right, and here he is, a sailing and questioning the most widely used medication in basically all

of mental health. Right, so after the confirmation hearings at the beginning of 2025,

“I think we were all watching closely to see what was the actually planning to do.”

And at the beginning of May, Secretary Kennedy appeared at a summit on over medicalization. It was held by the Maha Institute and Inter Compass Initiative, which is a support organization for people going off mental health medications. The thesis of the entire day was overuse of SSRIs, and at the end of that day, he announced a set of regulatory changes that all kind of aimed to encourage clinicians

to help patients get off SSRIs. So he's beginning to articulate a kind of federal regulatory vision for deep prescription. What specifically is he proposing? He sent a dear colleague letter, which is direct communication to hospitals and doctors, and the dear colleague letter essentially said, "Don't default to using medication

for depression and anxiety, look at other modes of treatment." And we know that lots of things are effective treatments for depression and anxiety, psychotherapies, probably the number one alternate mode, but also sleep and exercise and diet and lots of other things. So that is sort of common sense advice. It wasn't controversial.

And just to be clear, he's an doctor, our occasionally, but he's basically writing a letter

to colleagues in the world of public health and the medical community. Correct. And then he introduced a billing code that would allow Medicare and Medicaid providers to be reimbursed for helping patients get off medications. And why is that important? It's important because it can be complicated and time-consuming to help people

quit a psychiatric medication, especially if they've been taking it for a long time, or they're taking a complicated cocktail of four or five psychiatric medications. It takes a lot of time and usually psychiatrists are reimbursed for 15-minute medchecks every month. That's just not enough time. So he's financially attempting to incentivize doctors to participate in depression.

Yes. And another thing he said in motion is what's called a technical expert panel to develop guidelines for tapering off SSRIs. And this panel would create a new set of recommendations for healthcare providers on how best to do this. And what's the reaction to these proposals to this speech from the Secretary of Health and Human

“Services from the world of medical experts out there?”

Yeah, I was really curious about that because it was noticeable that there were no medical organizations involved in putting together this sort of day of policy making around the use of SSRIs. And when I reached out to them, I think there was a degree of alarm that they had somehow been excluded from this process, which sort of drives it, you know, one of the central functions of psychiatry. And I had an opportunity to find out a little bit more about that because

the American Psychiatric Association held its annual meeting 10 days later. That is extremely convenient, journalistically. I'm going to assume you went. What did you find? What I found was kind of two-fold. Some people that I talked to were worried that this was just

the first step in a much more ambitious plan on the side of Secretary Kennedy that would lead to a

bigger discrediting of psychiatric treatments. So their fear is that whatever this is, it's just the beginning, maybe a side door into greater government, what perhaps restrictions on these drugs. So a lot of doctors who I interviewed in the hallways outside sessions at the APA said that SSRIs are the foundation of their practice that they are so safe, that they've been using them for so many years and that they turn people's lives around, they make the difference between

being able to get up in the morning and get dressed and get to work and not being able to do those things. So a lot of them were kind of passionate about saying what they have seen with patients.

“And I think the worry is that people are going to be driven away from taking medications”

or that somehow their access will be restricted. How many doctors at this conference were open to or even in agreement with what RFK Jr is talking about here when it comes to de-prescription?

number of doctors there agreed that this is an area where we could do a lot better.

“That is training of psychiatrists focuses a great deal on putting people on medications, but much less”

on what it means to take them off and what a challenge it can be. And a number of people I interviewed expressed frustration over that. In one of the panels that I attended, a doctor Ronald Winshal from Columbia University School of Medicine said that when he looked back at his long career, one of the things that he most regretted is not taking patients off medications until later than he should have. That is hesitating for various reasons, even when he thought that

the medication was no longer needed or no longer effective. It sounds like the second group of doctors

you're talking to feel like RFK Jr has identified a problem in their world that everyone should be

“more focused on. Yeah, I think there was a lot of discussion of de-prescribing at this conference.”

There was a number of panels on de-prescribing different classes of medications. There was a new de-prescribing handbook and it was selling a lot downstairs in the exhibition hall. In conversations with doctors, a number of them acknowledge that this is an area where we could do a lot better at supporting patients. One thing we haven't talked about here is objective research that would clarify the questions. We're discussing. If Ellen the assumption now is that doctors aren't talking

enough about getting off these drugs that's certainly the case RFK Jr's making, some doctors are making it too. The implication is that people are on these drugs for too long. So what does

the research tell us about long-term use of SSRIs? The reality is that there isn't all that much

research on that. Most of the clinical trials we have on these drugs are efficacy trials and their shorter term, like six to eight week trials that are necessary for FDA approval. There's some longer term work, but very little that tells us what happens after three years or five years or ten years. I think when SSRIs were first introduced in the 1980s, it wasn't anticipated that people would be taking them for years and years. The clinical guidelines say once someone's symptoms

“are in remission that you should discontinue the medication after six, nine, 12 months and just”

go back off. But I think we see in reality that for a lot of people, that's just not happening. So one study found that the median duration of treatment with an SSRI is five years and for many, it's a lot longer than that. That amazes me to be honest that we don't have much of any long-term research on what has become for so many people long-term treatments. And if millions and minds of people are taking these prescription drugs for years and years and years, it's deeply surprising that

we don't know clinically what the impact of that is. Right, that kind of research just hasn't been a priority. So in the weeks since RFK junior introduced these ideas and once the medical health world began to absorb them, what has actually happened to these proposals? Well, the incoming president of the APA is going to have a seat on one of the technical expert panels that will be developing guidelines in this area. There's also psychiatrists from the American Society of

Clinical Psychopharmacology. So there are going to be representatives of sort of major professional groups at the table. Got it. So a lot of these medical experts decided that even if they were skeptical of RFK junior's agenda here, that they wanted to be a part of it. If you can't beat them, join them, shape them. They wanted to seat at the table. I mean, as this steeper scribing project gets off the ground, it's involving both establishment mainstream psychiatry and across the table

representatives of a totally different group that has been watching psychiatry critically from the outside for a long time. And that includes patients who are saying, "How long are we supposed to be on these things?" And why haven't we been having these conversations with our doctors the whole time?

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“and disinformation. It's never been more important to have reliable sources of on-the-ground reporting.”

If you want first hand reporting on how U.S. policy affects the world, consider subscribing to the New York Times. Ellen, I want to turn to this world of patients who have been eager for this deep prescription conversation to reach the point that it now has, where the federal government is broaching it and medical experts are now joining the conversation. And in particular, I want to

better understand the specific reasons that patients are giving for wanting to get off these medications

and the specific experiences that lead them to that decision. Well, whenever I write about this subject, we really get inundated with personal stories. And people have different reasons for wanting to get off a medication. I thought,

“like, if I get off any questions, I can see what life is without this numbness.”

Sometimes they feel like their emotions have been kind of muffled. I wasn't having these anxious thoughts, but I also wasn't experiencing like as much high good emotions either. There was like delayed sexual side effects. Sometimes they have side effects. Sometimes they feel that the medication just isn't working anymore. Maybe it's the classic thing. Oh, I feel great. I will not need my medication anymore.

By then, I had been on the medication for about 25 years. And there was this curious, what would my life be like without this? And I've heard from a lot of people who said, you know, I started taking this medication when I was a teenager and maybe that's what I needed to get through that period, but now many years have passed and I've entered adulthood, not exactly knowing who I was. Right. Who you would be without those drugs? Exactly. It's fullmo. It's like,

what am I missing out on? I want to live in real life. I don't want to live in like a white, I want to live in color, you know? Like those intense emotions that can feel so uncomfortable, especially when you're a very young person. They're also part of your personality. And I hear from people who say, like, I want to know who that person is. Once these people you're hearing from decide that they're going to try to stop taking these medications,

“how have they actually technically been doing that? And who is guiding them through that process?”

I mean, I think some people work with their doctors in getting off or tapering a medication and some people don't. I went in and they were like, hey, you want a refill of your soul often. I was like, yes, I guess, if I still need to be on it, they were like, cool. A lot of the people we hear from say this conversation about how to get off isn't happening with their doctor or if it is happening, it isn't satisfying. Or for others, they just don't

see their doctor often enough to get the kind of robust support that they need. I'm not going to see all doctors, but I don't know if how many doctors really grasp what it is beyond antipressant. Like, if you go in there and you're feeling depressed, they say,

all right, then you just raise the medication. Some are better than others, but I never really

go to them to get off it. I did that myself. And in some cases, people just lose trust in their doctor if they think that the medication that they've been prescribed is making them worse. I'll be honest. I at this point, because I've been just missed about everything else. I was like, I don't trust these people. I can make my own health decisions. And those people have been talking to each other now for years and years, with a lot of frustration towards organized medicine.

And for those folks who have been trying to do this essentially DIY, what has been their playbook for lack of a better word. What does it look like? I use Dr. Google and I look at forums on Reddit

So the kind of subculture around tapering and withdrawing from medications has been out there

since the early days of social media. One example is a site called surviving antidepressants. And what you would find there is people exchanging their withdrawal protocols and it got incredibly technical. People would be talking about reducing their dosage by a single bead within the capsule or liquifying it or using pharmaceutical scales. And over time, that network has sort of matured into a real marketplace of support. And that's presumably to avoid the

side effects of abruptly taking yourself off of one of these drugs. But even when people are very

“careful and very gradual, what are the side effects of ending these treatments?”

The side effects that you most often hear about are vertical, nausea, or flu-like symptoms. I completely stopped sleeping. In Somnia, something that they call brain saps, electricity in my head, which are like a twinge or a sense of a feeling of sort of a shock-like sensation in the brain. Wow, it's like this kind of thing. And there's some portion of people who describe the process of withdrawal is really intolerable like jumping out of their skin and it

is its own kind of debilitating crisis. I was like watching a movie a cry. I was commercial and cried. I read a book and I cried. I was listening to the Beach Boys Pet Sound's album and

“just here's going to my eyes. It felt good for a while, but then it was like it was like going”

like having emotions that were like a dripping faucet to like a fire hose. Just too much. But what doctors generally say is that for most people these symptoms really only last for a few weeks. And then, after that, you're feeling traumatic mood changes, you might be experiencing

relapse. Essentially, the conditions that may have prompted you to first go on these drugs. Yes.

However severe these side effects are, they would seem to buttress the argument that the best version of deep prescription is a medically supervised one where you're not trying to do it yourself and you're not determining dosages and tapering and where the same doctor who prescribed the drug is the one helping you get off of them and aware that you're trying to do it and helping you manage what could be a brains app or a resumption of symptoms. It feels like something that should not

be DIY. That's certainly the view from within medicine that one of the reasons that you need supervision, if you're doing something like this, is just to guard against the possibility of a relapse. And this would seem to make the case for the conversation that RFK is pushing the medical

“world to have. Right. I think there is some acknowledgement that prescribers aren't putting the”

same amount of care and attention into landing the plane as taking off. Well, and here I want to acknowledge that the conversation that RFK is trying to have and that we're having here is not theoretical for me anyway and here I'm going to shake my lexapro. I've been on lexapro as an anti-anxiety medication for at least a decade. It was prescribed by a psychiatrist, but then just became part of my relationship with my general practitioner. I just kind of get it renewed and I've

not really been asked to think about how long I should be on it. And now suddenly having this conversation with you is making me ask that question. How long am I supposed to be on it? What would happen if I stopped taking it? Would all the white noise of anxiety that made me want to go on lexapro? Would that return or 10 years later have I outgrown that? And I just don't

know it because I've never tried to taper myself off this to find out who I would be if I weren't

me on lexapro. I mean it's not a simple question. I hear so many people asking that kind of question. Like is there some authentic self that I want to go back to what would life look like

what's a little bit more complicated is if you think it works for you, you become sort of, I don't know, psychologically attached to them. And you think if I quit this, am I going to spiral, am I going to feel bad again? And we know that the placebo effect is a huge part of the picture with these medications. And I think it's the same when you go off. They call it the no-sebo effect,

which is if you think it's essential to you, you may be just afraid of stomping,

afraid of finding out what that's like. And that could sort of contribute to your feeling that mm-hmm. Michael, in your case, what did you conclude about stopping? Me, I don't know that I've ever gotten far enough along in the conversation with myself to stop. I just know that on the occasions when I have failed to reliably take lexapro, I have experienced some really crippling headaches, which I needed a doctor to tell me

were from not taking my lexapro reliably, but there was no deeper conversation. There was no

“is it time to think about whether you should be tapering? How long have you been on it? It was just”

an accepted fact in my conversation with a doctor that I was on it. And then I'd probably still be on it. For as long as I'm going to be on it. And do you think that that conversation should have happened

when you first went on? I wonder now. But now I'm asking myself the question of are we all

infantilizing ourselves in the face of medicine? Should I be asking this question myself? Why should I be waiting for a doctor to ask it? It's getting a little existential now. I mean, some people have multiple remissions and what I hear from physicians is if you've had like three episodes of depression, then you probably are going to take an SSRI for indefinitely as a maintenance treatment. And if it's fewer than three, then no, then you should

try to get off if you want. But I don't think there's a lot of energy around having that conversation. Right. I mean, we're talking about deep prescription here because that's the conversation that RFK Jr and those around him want us to be having. But there's also a possibility that people are going to hear this conversation. And instead of just deep prescription, they're going to hear, maybe I shouldn't ever get a prescription. And I wonder if that's a risk that RFK Jr and the

medical experts who are now joining him in this conversation are thinking about. I mean, because I cover psychiatry, mental health, I have been doing interviews all over the country about people's use of this kind of medication. And I'll tell you that like they're reaching parts of society that just wouldn't have gotten any kind of mental health care in the past.

“So I remember talking to, I think he was an automatic and I was doing interviews at his school”

parking lot. And he said, you know, like my father was an angry drunk. And because I take an anti-depressant, I know I'm not going to go that way. And there are groups within our society that are only now for the first time getting access to a treatment for depression or a treatment for anxiety. I mean, I think if you look at the numbers, white people take any depressants at a rate that is twice as high as any other racial category. And like five times as high as Asian people.

So there's just a huge discrepancy. Some groups take these a lot. Some groups really don't have much access. In other words, because of the demographics of who takes these mental health drugs,

there are plenty of people who perhaps could benefit from them, who have never been introduced to them,

or are just starting culturally to accept the idea that they can and will be on them. And the over-prescription, deep prescription conversation isn't necessarily the right one for them

“to be having right now. Yeah, I think that's right. I mean, it may be that there is no one”

message that is appropriate for our entire society. So I think RFK Jr. the secretary has to be very careful about encouraging this conversation about stopping medication when it's appropriate without driving people away from the idea of treatment completely. Right, it's one thing to have a conversation about deep prescription. It's another to intentionally or not stigmatize ever getting a prescription. Yeah, I think both of these conversations need to happen,

how to access treatment that people really desperately need and also how much is enough and how to

We'll be right back.

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“Here's what else you need to know today. As a new round of peace talks started between the US and”

Iran on Sunday, the conflict between Israel and Hezbollah in Lebanon through a ranch into the negotiations. Fighting between Israel and Hezbollah prompted Iran to claim it was once again closing the street of Hormuz, a threat US officials said had not been carried out. Iran has demanded that fighting in Lebanon and immediately, but ceasefires there have been

“declared broken and reinstated several times over the past few weeks.”

And problems with President Trump's $14 million renovation of the Lincoln Memorial reflecting poll. Time for America's 250th birthday next month have become so severe that Trump said he will have to partially drain the poll for repairs. Over the past few days, the poll's new

code of dark blue paint, applied by a company that is never before worked for the federal government,

has begun to visibly peel and green algae has spread across the pool. likely because the renovation project does not fix the poll's malfunctioning filtration system. Today's episode was produced by Alex Stern, Jack Disodoro, Claire Tenisketter, and Stella Tan, with help from Anna Foley and Olivia Nat. It was edited by MJ Davis Lynn, with help from Brendan Klinkenberg, and contains music by Pat McCusker and Dan Powell.

This episode was engineered by Alyssa Moxley. That's it for The Daily. I'm McCable Borough. See you tomorrow! This week on The Wire Cutter Show, the cost of consumer tech products, laptops, phones, gaming consoles is climbing. We have built a world that makes people need this stuff, and increasingly it's going to be very difficult for a broad category of people to afford.

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