Health Secretary Robert F. Kennedy Jr. on Monday announced several initiatives intended to rein in the prescription of selective serotonin reuptake inhibitors, the most widely prescribed class of antidepressants, which he has described as exceptionally difficult to quit.<\/p>\n
Mr. Kennedy has long signaled<\/a> that reducing the use of psychiatric drugs would be an aim of his tenure, but Monday\u2019s announcements were the first significant step<\/a> in that direction.<\/p>\n The initiative focuses on the most widely prescribed class of psychiatric medications, first-line treatments for depression and anxiety that include Zoloft, Lexapro, Paxil and Prozac. In 2026, 16.6 percent of U.S. adults<\/a>, or roughly one in six, reported currently taking an S.S.R.I.<\/p>\n Introduced nearly 40 years ago, the drugs surged in popularity, partly because they had fewer side effects than previous antidepressants and could be prescribed by general practitioners. Clinicians typically told patients that going off S.S.R.I.s was straightforward. But many patients report withdrawal symptoms, including \u201cbrain zaps,\u201d restlessness and flulike symptoms, and say they have received little support from clinicians in the process.<\/p>\n The changes \u2014 new trainings, reimbursement mechanisms and clinical guidelines \u2014 nudge clinicians to help patients getting off medications, and to consider nonpharmaceutical interventions, like therapy, nutrition and exercise.<\/p>\n \u201cPsychiatric medications have a role in care, but we will no longer treat them as the default, we will treat them as one option, to be used when appropriate, with full transparency and with a clear path off when they are no longer needed,\u201d Mr. Kennedy said at a Mental Health and Overmedicalization Summit organized by the MAHA Institute.<\/p>\n While some patients benefit from S.S.R.I.s, he said, others report emotional blunting, loss of motivation, suicidal ideation and difficulty in withdrawing.<\/p>\n \u201cLet me be clear: If you are taking psychiatric medication, we are not telling you to stop,\u201d Mr. Kennedy said. \u201cWe are making sure you \u2014 and your clinician \u2014 have the information and support to make the right decision for you.\u201d<\/p>\n No major medical organizations were represented at the gathering, and afterward, some pushed back at the assertion that psychiatric medications were overprescribed.<\/p>\n \u201cWe may take issue with this blanket \u2018overprescribing\u2019 hypothesis that underpins the secretary\u2019s statements,\u201d said Dr. Marketa Wills, the chief executive and medical director of the American Psychiatric Association. \u201cThere is probably overprescribing and underprescribing in all parts of medicine, and mental health care is no different. And there are people who still can\u2019t access care at all who need it.\u201d<\/p>\n She added, though, that she welcomed Mr. Kennedy\u2019s focus on mental health, and that she hoped to be involved in developing clinical guidelines around deprescribing.<\/p>\n \u201cWe, as the A.P.A., want to be at the table for all these discussions and policy improvements,\u201d she said. \u201cThe bottom line is, we believe clinical care is safe and should be individualized for all patients, and we believe the secretary is taking steps that are beneficial for the field.\u201d<\/p>\n Federal agencies have various levers to influence prescribing decisions, through reimbursement rules and regulatory actions, and Mr. Kennedy plans to use several of them. The Centers for Medicare and Medicaid Services is introducing a mechanism that will allow clinicians to be paid for time spent helping a patient get off medications, he said.<\/p>\n In addition, the Department of Health and Human Services will convene a technical expert panel to develop clinical guidelines for deprescribing, and this summer, the Substance Abuse and Mental Health Services Administration, or SAMHSA, will release training modules focusing on the risks of psychiatric medications and on tapering and deprescribing.<\/p>\n Mr. Kennedy also released a \u201cDear Colleague\u201d letter<\/a> directing providers \u201cto expand the use of nonpharmacologic treatments and to strengthen informed consent and shared decision making.\u201d The letter recommends psychotherapy, exercise, social connection, physical activity, diet and nutrition, among other interventions.<\/p>\n \u201cOur goal is straightforward: to reduce unnecessary dependence on medication, to improve patient outcomes and to return control to the patients,\u201d he said.<\/p>\n It is difficult to say what effect the initiatives will have on prescribing practices, which are determined together by patients and their providers.<\/p>\n The United States could follow the lead of Britain, which commissioned a major report on overprescribing<\/a> and then followed up with a series of reforms, including updating clinical prescribing guidelines for the National Health Service and instituting a national audit program to monitor prescribers\u2019 drug use.<\/p>\n Many people report withdrawal symptoms after lowering a dose or stopping an antidepressant. The symptoms may include \u201cbrain zaps,\u201d which are shocklike sensations, flulike symptoms, insomnia, nausea and restlessness.<\/p>\n The prevalence and severity of those symptoms has been a subject of debate. In 2019, two British researchers published a study that found that 56 percent of patients suffered from withdrawal symptoms<\/a> when they stopped antidepressant medications and that 46 percent of those described their symptoms as severe<\/a>.<\/p>\n Subsequent studies have found<\/a> less widespread withdrawal effects. In 2024, a team of German researchers, after controlling for a placebo effect, concluded that only about one in six people<\/a> reported withdrawal effects, and that a much smaller number, around 3 percent of patients, experienced severe withdrawal.<\/p>\n