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The Daily (NYT)

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

31 min episode · 2 min read
·
Ellen Barry

Episode

31 min

Read time

2 min

Topics

Career Growth, Health & Wellness, Psychology & Behavior

AI-Generated Summary

Key Takeaways

  • Deprescribing policy levers: RFK Jr. introduced three concrete federal mechanisms to encourage SSRI tapering: a "dear colleague" letter to clinicians recommending non-medication alternatives like psychotherapy, sleep, and exercise; a new Medicare/Medicaid billing code reimbursing providers for tapering consultations; and a technical expert panel tasked with developing formal tapering guidelines for health care providers.
  • The research gap on long-term SSRI use: FDA approval trials for SSRIs run only six to eight weeks, and almost no clinical data exists on outcomes beyond three to five years. Yet the median real-world treatment duration is five years, with many patients on SSRIs far longer — meaning tens of millions take these drugs with no evidence base for their long-term use.
  • Clinical guidelines vs. reality: Standard guidelines recommend discontinuing SSRIs six to twelve months after symptom remission, but this rarely happens in practice. Psychiatrists trained primarily in initiating medication receive minimal training in tapering. One Columbia University physician publicly acknowledged regretting keeping patients on medications longer than necessary throughout his career.
  • DIY tapering risks and methods: Patients tapering without medical supervision use forums like Surviving Antidepressants, reducing dosages by single capsule beads or liquefying pills with pharmaceutical scales. Withdrawal symptoms include vertigo, insomnia, and brain zaps. Doctors note symptoms typically resolve within weeks, but abrupt cessation risks destabilizing patients and triggering relapse of the original condition.
  • Access disparity complicates the narrative: White Americans take antidepressants at twice the rate of other racial groups and five times the rate of Asian Americans. Broad public messaging about overprescription risks discouraging treatment among populations only recently gaining cultural and practical access to mental health care, making a single universal message on SSRIs inappropriate.

What It Covers

NYT reporter Ellen Barry examines RFK Jr.'s federal push to encourage deprescribing of SSRIs, used by roughly 35 million American adults. The episode explores the gap between how doctors start psychiatric medications versus stop them, the patient-led tapering movement, and the risks of both over- and under-treatment.

Key Questions Answered

  • Deprescribing policy levers: RFK Jr. introduced three concrete federal mechanisms to encourage SSRI tapering: a "dear colleague" letter to clinicians recommending non-medication alternatives like psychotherapy, sleep, and exercise; a new Medicare/Medicaid billing code reimbursing providers for tapering consultations; and a technical expert panel tasked with developing formal tapering guidelines for health care providers.
  • The research gap on long-term SSRI use: FDA approval trials for SSRIs run only six to eight weeks, and almost no clinical data exists on outcomes beyond three to five years. Yet the median real-world treatment duration is five years, with many patients on SSRIs far longer — meaning tens of millions take these drugs with no evidence base for their long-term use.
  • Clinical guidelines vs. reality: Standard guidelines recommend discontinuing SSRIs six to twelve months after symptom remission, but this rarely happens in practice. Psychiatrists trained primarily in initiating medication receive minimal training in tapering. One Columbia University physician publicly acknowledged regretting keeping patients on medications longer than necessary throughout his career.
  • DIY tapering risks and methods: Patients tapering without medical supervision use forums like Surviving Antidepressants, reducing dosages by single capsule beads or liquefying pills with pharmaceutical scales. Withdrawal symptoms include vertigo, insomnia, and brain zaps. Doctors note symptoms typically resolve within weeks, but abrupt cessation risks destabilizing patients and triggering relapse of the original condition.
  • Access disparity complicates the narrative: White Americans take antidepressants at twice the rate of other racial groups and five times the rate of Asian Americans. Broad public messaging about overprescription risks discouraging treatment among populations only recently gaining cultural and practical access to mental health care, making a single universal message on SSRIs inappropriate.

Notable Moment

Host Michael Barbaro disclosed on-air that he has taken Lexapro for over a decade for anxiety, prescribed initially by a psychiatrist but now simply auto-renewed by his GP — with no doctor ever raising the question of whether he should consider tapering or reassessing his ongoing need for the medication.

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Episode Transcript

With no fees or minimums on checking accounts, it's no wonder the Capital One bank guy is so passionate about banking with Capital One. If he were here, he wouldn't just tell you about no fees or minimums. He'd also talk about how Capital One cafes are open seven days a week to assist with your banking needs. Yep. Even on weekends. It's pretty much all he talks about in a good way. What's in your wallet? Terms apply. See capital1.com/bankguy. Capital One, n a, member FDIC. From the New York Times, I'm Michael Barbaro. This is The Daily. In his latest public health crusade, Robert f Kennedy junior is asking why millions of Americans have been taking psychiatric drugs for far longer than ever intended. I have been on Zoloft since I was eight years old. I've continuously been on antidepressants twenty seven years. I've been on Luvox thirty 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, that doctors are much better at starting drug treatments than at stopping them. I was told to take it daily, and 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 gonna be on them for the rest of my life. And that patients who wanna 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 deprescribe. It's Monday, June 22. 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 deprescribing. And for the uninitiated, can you just define that phrase? Deprescribing 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 sort of 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 wanna thank president Trump for entrusting me to deliver on his promise to make America healthy again. Doctor 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. Fifteen percent of American youth are now on Adderall or some other ADHD medication. …

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Tools

  • Patients tapering without medical supervision use forums like Surviving Antidepressants, reducing dosages by single capsule beads or liquefying pills with pharmaceutical scales.

Products

  • Host Michael Barbaro disclosed on-air that he has taken Lexapro for over a decade for anxiety, prescribed initially by a psychiatrist but now simply auto-renewed by his GP.

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