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.
Mr. Kennedy has long signaled that reducing the use of psychiatric drugs would be an aim of his tenure, but Monday’s announcements were the first significant step in that direction.
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, or roughly one in six, reported currently taking an S.S.R.I.
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 “brain zaps,” restlessness and flulike symptoms, and say they have received little support from clinicians in the process.
The changes — new trainings, reimbursement mechanisms and clinical guidelines — nudge clinicians to help patients getting off medications, and to consider nonpharmaceutical interventions, like therapy, nutrition and exercise.
“Psychiatric 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,” Mr. Kennedy said at a Mental Health and Overmedicalization Summit organized by the MAHA Institute.
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.
“Let me be clear: If you are taking psychiatric medication, we are not telling you to stop,” Mr. Kennedy said. “We are making sure you — and your clinician — have the information and support to make the right decision for you.”
No major medical organizations were represented at the gathering, and afterward, some pushed back at the assertion that psychiatric medications were overprescribed.
“We may take issue with this blanket ‘overprescribing’ hypothesis that underpins the secretary’s statements,” said Dr. Marketa Wills, the chief executive and medical director of the American Psychiatric Association. “There is probably overprescribing and underprescribing in all parts of medicine, and mental health care is no different. And there are people who still can’t access care at all who need it.”
She added, though, that she welcomed Mr. Kennedy’s focus on mental health, and that she hoped to be involved in developing clinical guidelines around deprescribing.
“We, as the A.P.A., want to be at the table for all these discussions and policy improvements,” she said. “The 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.”
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.
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.
Mr. Kennedy also released a “Dear Colleague” letter directing providers “to expand the use of nonpharmacologic treatments and to strengthen informed consent and shared decision making.” The letter recommends psychotherapy, exercise, social connection, physical activity, diet and nutrition, among other interventions.
“Our goal is straightforward: to reduce unnecessary dependence on medication, to improve patient outcomes and to return control to the patients,” he said.
It is difficult to say what effect the initiatives will have on prescribing practices, which are determined together by patients and their providers.
The United States could follow the lead of Britain, which commissioned a major report on overprescribing 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’ drug use.
Many people report withdrawal symptoms after lowering a dose or stopping an antidepressant. The symptoms may include “brain zaps,” which are shocklike sensations, flulike symptoms, insomnia, nausea and restlessness.
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 when they stopped antidepressant medications and that 46 percent of those described their symptoms as severe.
Subsequent studies have found 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 reported withdrawal effects, and that a much smaller number, around 3 percent of patients, experienced severe withdrawal.
During his confirmation hearings last year, Mr. Kennedy claimed, without evidence, that S.S.R.I.s were partly responsible for the rise in school shootings, and that they could be harder to quit than heroin. At Monday’s event, Mr. Kennedy repeated that claim.
“I happen to be an actual expert, because I was addicted to heroin for 14 years, and I never wanted to be,” he said. “I was constantly getting off it, and then came back on. I went through withdrawal probably 100 times,” he added. “You just have to steel yourself for 72 bad hours.”
He contrasted this experience with the ordeal of an unnamed family member who he said “was suicidal, literally every day” when she discontinued an S.S.R.I. after taking it for several years. “That’s heartbreaking to hear from a family member,” he said. “And I’ve heard that from hundreds, hundreds of people, the same story again and again.”
At the daylong summit, speakers advocated a variety of steps to address the overprescription of psychiatric medications, such as phasing out school-based mental health screenings, requiring written informed consent before starting medications and featuring prominent, cigarette-style warnings on packaging.
Laura Delano, an author and former psychiatric patient who founded Inner Compass, a nonprofit group that supports people who are quitting medications, described spending her teenage years “on two medications, then three, then four, then five,” leaving her in despair, her emotions blunted.
Under Mr. Kennedy’s leadership, she said, she has seen the peer-led, grass-roots effort to help patients get off medications grow into a potent force, with backers inside government.
“We are now waking up to the false promises of this industry called mental health,” Ms. Delano said. “Time has run out on this deceptive mythology. Our culture sees through it now. A couple of years ago, I could never in my wildest dreams have imagined that we would reach this tipping point.”