{"id":101862,"date":"2025-05-14T22:00:10","date_gmt":"2025-05-14T22:00:10","guid":{"rendered":"https:\/\/www.europesays.com\/uk\/101862\/"},"modified":"2025-05-14T22:00:10","modified_gmt":"2025-05-14T22:00:10","slug":"post-ssri-era-new-clinic-outro-for-patients-to-taper-off-antidepressants","status":"publish","type":"post","link":"https:\/\/www.europesays.com\/uk\/101862\/","title":{"rendered":"Post-SSRI Era: New Clinic, Outro, for Patients to Taper Off Antidepressants"},"content":{"rendered":"

When Mark Horowitz first decided to quit his antidepressants<\/a> in 2015, he’d heard that it usually takes a few weeks, maybe a few months, at most, for a person to safely wean off their meds.<\/p>\n

It’s taken him about 10 years to completely off-ramp himself, including one initial and “catastrophic” experience that made him so anxious<\/a> he tried to literally outrun the experience, jogging so hard that his feet bled. He said that he <\/strong>also, for the first time, thought of killing himself.<\/p>\n

“I feel like I’ve learned a very costly lesson about the harms and benefits of the drugs in the long term,” Horowitz, a psychiatry researcher who’s become one of the world’s leading advocates for deprescribing antidepressants<\/a>, told Business Insider.<\/p>\n

\"mark<\/p>\n

Mark Horowitz in London in 2022.<\/p>\n

Daniel Jackont<\/p>\n

Now, he’s going commercial, harnessing his years of formal and informal study to cofound a first-of-its-kind American antidepressant “deprescribing” clinic, a cash-pay version of what he offers for free at a London clinic that’s part of the UK’s National Health Service.<\/p>\n

The new American company is called Outro<\/a>, and it’s launching telehealth clinics<\/a> in seven US states: California, Colorado, Florida, Illinois, New York, Texas, and Washington.<\/p>\n

The clinics, operating entirely online, are geared toward helping people slowly discontinue five of the most common anxiety and depression medications<\/a>, including Prozac, Zoloft, and Lexapro \u2014 ideally without the severe, but relatively common, withdrawal symptoms<\/a> that Horowitz experienced.<\/p>\n

Roughly one in 10 American adults are taking drugs for depression at any time, per CDC data, and the number of young adults under 25 taking antidepressants has been on a particularly steep rise since the COVID-19 pandemic.<\/p>\n

Most psychiatrists agree that patients should get help weaning off the drugs. Some have voiced concern about a growing movement<\/a> encouraging people to quit psychiatric medication without medical support \u2014 in some cases, with unqualified coaches offering counseling for a fee.<\/p>\n

“Many patients are parked on antidepressants unnecessarily,” Dr. Mimi Winsberg, a clinical psychiatrist in California who is not involved with Outro, told Business Insider.<\/p>\n

“I’ve always been an advocate of tapering antidepressants when it’s appropriate,” <\/strong>Winsberg, the cofounder and chief medical officer at Brightside<\/a>, an online mental health company, which uses therapy and drugs to treat mood, anxiety, alcohol and substance use disorders<\/a>, said.<\/p>\n

Still, whether people need an out-of-pocket pill-compounding service to help them do so is up for debate.<\/p>\n

Related stories<\/p>\n

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Business Insider tells the innovative stories you want to know<\/p>\n

\"\"\/<\/p>\n

Business Insider tells the innovative stories you want to know<\/p>\n

An internet craze moves into clinical practice<\/strong><\/p>\n

\"outro<\/p>\n

Outro is geared toward patients who may have already tried to quit their antidepressant and failed. The company says more than 85% of their patients have tried to stop once before, and more than 60% have tried to stop at least twice.<\/p>\n

Outro<\/p>\n

For decades, Horowitz said, doctors had been taught that the drugs are effective, side effects are minimal, and quitting takes weeks.<\/p>\n

Slowly, that framework has been shifting, with the recognition that these medications are not one size fits all, and more careful withdrawal schedules<\/a> are needed. There’s been a growing recognition that something called “antidepressant continuation syndrome” is real, and may impact between 15% and 20% of patients who are trying to stop treatment.<\/p>\n

Medical experts may still quibble about the finer details of the issue, but they generally agree<\/a> that most patients trying to quit antidepressants will experience some kind of withdrawal, whether mild or severe.<\/p>\n

\"outro<\/p>\n

A screenshot of the Outro platform. The company says its monthly plans will cost between $125 and $295.<\/p>\n

Outro<\/p>\n

In the UK, where he is based, Horowitz was part of a national reckoning about how the drugs are used. In addition to igniting an online firestorm about whether there’s really a “chemical imbalance” of low serotonin<\/a> being corrected by antidepressants, he published a widely cited 2019 paper<\/a>, “Tapering of SSRI treatment to mitigate withdrawal symptoms.” The study was one of the first to suggest that tapering should be done in doses much lower than you can get by just cutting up pills at home.<\/p>\n

He has also opened a deprescribing clinic<\/a> in London, and coauthored a best-selling handbook<\/a> for clinicians that’s the Maudsley Prescribing Guidelines’ first deprescribing reference. The UK’s NHS is now encouraging<\/a> doctors to do more “social prescribing” for their patients, through initiatives like insomnia support groups, art and music classes, or more time outdoors for mental health.<\/p>\n

In the US, Horowitz says, the overprescription problem has persisted, with many patients not getting the advice they need to properly taper. Since he went public with his own struggles a couple of years ago, Horowitz says he’s received over 20,000 emails, “mostly from Americans asking me to help them come off their drugs.”<\/p>\n

Winsberg says this may be because the US has a more decentralized healthcare system than the UK. As a result, help with deprescribing is highly variable.<\/p>\n

Some \u2014 including, at one point, Horowitz himself \u2014 find themselves digging through online communities on Facebook or Reddit, looking for advice or to share their best practices for how to come off these medications without the mild to severe insomnia, anxiety, panic, fatigue, stomach problems, tingly fingers, and suicidal thoughts that can result from quitting too quickly.<\/p>\n

Outro’s equipment includes oral syringes and compounded microdoses. Some say that’s overkill.<\/strong><\/p>\n

\"kid<\/p>\n

Oral syringes are common in pediatrics, but it’s unusual for adults to use them.<\/p>\n

Kunlathida Petchuen\/Getty Images<\/p>\n

Outro entered US beta mode last summer. Around 100 American patients have tried the service, which is staffed by nurse practitioners and psychiatrists trained in Horowitz’s methods.<\/p>\n

For patients who don’t have a doctor who knows as much about tapering, it’s possible Outro could help fill a gap. Outro uses a risk calculator Horowitz developed to help determine the best deprescribing schedule for a particular patient. It considers factors including how long a person has been on a medication and why they’re on it. The program is designed to last between one and two years, but the schedule can vary.<\/p>\n

During Outro’s deprescribing, patients have regular check-ins with clinicians. Some patients gradually lower their dosage once a month using compounded pills, while others use a syringe to take incrementally smaller and smaller doses of their drug each day.<\/p>\n

The method taps into patient demand for personalized, precision medicine<\/a>, though it’s unclear how many patients require \u2014 or stand to benefit \u2014 from new doses that aren’t already available in pharmacies.<\/p>\n

The company does not accept insurance (prices range from $125 to $295 a month, not including the compounded medicine).<\/p>\n

“Having to pay cash just to get off antidepressants when that should be in the wheelhouse of the provider that is prescribing those antidepressants is problematic,” Winsberg said. “To me, the problem is less about coming up with the perfect formula for tapering, it’s more about introducing the idea of tapering when it’s appropriate.”<\/p>\n

A holistic approach<\/p>\n

The psychiatric field still hasn’t cracked the code on how, exactly, antidepressant withdrawal syndrome manifests.<\/p>\n

We know it’s more common in female patients, and more than 70% of Outro’s patients are women. Should women time their tapering based on their menstrual cycle<\/a>? It’s something both Outro and Winsberg have considered.<\/p>\n

“We have more to learn about antidepressant discontinuation syndrome,” Winsberg said. “Does it mean the patient is relapsing? Does it mean that we need to more carefully perfect when they’re coming off?”<\/p>\n

Horowitz says he’s recruiting clinicians who are interested in exploring “lots of other things people can do to keep themselves from being depressed and anxious,” other than drugs. “They’re often into holistic health,” he added.<\/p>\n

That isn’t just a woo-woo line of thinking: There’s hard evidence suggesting that things like meditation<\/a> and exercise can be just as effective<\/a> as antidepressant medication in the long run.<\/p>\n

“Our hypothesis is that more and more people will want to explore getting off their antidepressant,” Horowitz’s Outro cofounder, Brandon Goode, said. “More and more people will reconsider if long-term or lifelong antidepressant use is actually right for them, because they will have a fuller picture.”<\/p>\n","protected":false},"excerpt":{"rendered":"When Mark Horowitz first decided to quit his antidepressants in 2015, he’d heard that it usually takes a…\n","protected":false},"author":2,"featured_media":101863,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[4315],"tags":[46263,9695,47106,47112,6579,105,47108,4326,47107,28746,457,47111,47109,16,15,47113,47110,3118],"class_list":{"0":"post-101862","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-medication","8":"tag-antidepressant","9":"tag-business-insider","10":"tag-clinic","11":"tag-common-anxiety","12":"tag-drug","13":"tag-health","14":"tag-mark-horowitz","15":"tag-medication","16":"tag-outro","17":"tag-patient","18":"tag-people","19":"tag-psychiatric-medication","20":"tag-tapering","21":"tag-uk","22":"tag-united-kingdom","23":"tag-us-state","24":"tag-winsberg","25":"tag-year"},"share_on_mastodon":{"url":"https:\/\/pubeurope.com\/@uk\/114508439482781924","error":""},"_links":{"self":[{"href":"https:\/\/www.europesays.com\/uk\/wp-json\/wp\/v2\/posts\/101862","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.europesays.com\/uk\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.europesays.com\/uk\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.europesays.com\/uk\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.europesays.com\/uk\/wp-json\/wp\/v2\/comments?post=101862"}],"version-history":[{"count":0,"href":"https:\/\/www.europesays.com\/uk\/wp-json\/wp\/v2\/posts\/101862\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.europesays.com\/uk\/wp-json\/wp\/v2\/media\/101863"}],"wp:attachment":[{"href":"https:\/\/www.europesays.com\/uk\/wp-json\/wp\/v2\/media?parent=101862"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.europesays.com\/uk\/wp-json\/wp\/v2\/categories?post=101862"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.europesays.com\/uk\/wp-json\/wp\/v2\/tags?post=101862"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}