As Health Secretary Robert F. Kennedy Jr. sets out to rein in the use of psychiatric medications, a group of prominent psychiatrists are developing guidance for helping patients to stop taking them, noting that providers sometimes \u201cpark\u201d patients on medications that are no longer necessary or effective.<\/p>\n
The experts, whose first recommendations appeared in JAMA Network Open<\/a> and the British Journal of Psychiatry<\/a>, identify structural problems that may lead to overprescribing: There are few clinical trials showing when it is advisable to stop a medication; many providers do not regularly review whether a prescription is still needed; and psychiatry residents receive more training in starting drug prescriptions than stopping them.<\/p>\n \u201cWe have not really taught our trainees to think about, what is the logical endpoint?\u201d said Dr. Joseph F. Goldberg, a past president of the American Society of Clinical Psychopharmacology, which convened a group of 45 psychiatrists to agree on basic principles for \u201cdeprescribing,\u201d as supervised drug tapering is sometimes called.<\/p>\n \u201cYou\u2019ll see a patient in consultation who has been parked on a medication which seems to be ineffective for years, and you\u2019ll ask, \u2018Why are you still on this medicine?\u2019\u201d he said. \u201cWe\u2019ve got a bugaboo going about passive re-prescribing, and I hope we\u2019ll see much less of that.\u201d<\/p>\n The new recommendations come amid rising pressure from Mr. Kennedy and his allies in the Make America Healthy Again movement, who have long made the case that Americans overuse psychiatric medications.<\/p>\n The Department of Health and Human Services will convene expert panels on deprescribing the main class of medication used to treat depression \u2014 selective serotonin reuptake inhibitors, or S.S.R.I.s \u2014 this summer, with an eye toward developing official guidance.<\/p>\n During Mr. Kennedy\u2019s confirmation hearings last year, he suggested that reducing the use of such drugs<\/a> would be a central aim of his tenure. In testimony, he claimed, without evidence,<\/a> that S.S.R.I.s have contributed to a rise in shootings, and that they can be harder to quit than heroin.<\/p>\n The recommendations from the A.S.C.P. are not binding, and represent a first pass at outlining best practices. They take a moderate approach, warning that it could be dangerous for patients to stop taking psychiatric drugs on their own, and that to avoid relapse, some may need to take a medication indefinitely.<\/p>\n By addressing the issue now, psychiatric groups hope to take a leading role in the conversation, steering it away from a broader rejection of psychotropic treatments.<\/p>\n Dr. Awais Aftab, a clinical associate professor of psychiatry at Case Western Reserve University and the author of a popular psychiatry newsletter on Substack<\/a>, said expert groups watched as \u201ccritics of psychiatry \u2014 especially radical critics of psychiatry \u2014 had gained more prominence in the deprescribing space and claimed that banner for themselves.\u201d<\/p>\n He welcomed the effort but said it has come late, after a growing number of patients<\/a> have spoken out publicly about the difficulties they have had coming off medications. The vacuum, he added, has been filled by professionals outside the medical mainstream who are \u201cskeptical of the reality of mental illness and the efficacy of psychiatric medications.\u201d<\/p>\n With their primary treatments questioned by Sec. Kennedy, psychiatric organizations have responded that medications used to treat depression, mania and psychosis have undergone decades of rigorous testing and analysis.<\/p>\n Medications allow many young people to participate fully in school, social activities and family life, and curtailing the drugs\u2019 use \u201cwill have serious deleterious consequences,\u201d said a joint statement<\/a> released last year by groups that included the American Psychiatric Association.<\/p>\n Use of psychiatric medications has risen steadily since 1988, when Prozac, the first selective serotonin reuptake inhibitor antidepressant, was introduced. By 2026, 16.6 percent of U.S. adults<\/a>, or roughly one in six, reported currently taking an S.S.R.I.<\/p>\n As use rose, more patients reported downsides, like decreased sexual desire. And some said that they experienced debilitating withdrawal symptoms when they stopped taking the medications, but got little support from their doctors. Many turned for support to social media, where peers advised one another on how best to go off the drugs.<\/p>\n