RFK Wants to Ban Antidepressants?

This is such a tired argument...

Hi 👋 friends,

In February 2025, Robert F. Kennedy Jr., newly appointed as the U.S. Secretary of Health and Human Services (HHS) under President Donald Trump, initiated a review on the use of antidepressant medication, particularly selective serotonin reuptake inhibitors (SSRIs) 💊.

Who am I?

Hi 👋 friends, thank you so much for subscribing to my newsletter. I’m Elliott, a doctor and psychiatrist in the UK I make content about mental health 🧠 and mental illness 👨‍⚕️ trying to help improve our understanding of mental health and documenting my own personal and professional journey along the way. My hope is that by sharing what I have learned and what I continue to learn that it will also help you live mentally healthier happier and more productive lives.

What has Kennedy said?

Kennedy is… bites tongue 👅 … a skeptic about many medical interventions and the use of SSRIs is no exception. In fact, during his confirmation hearings, he made the provocative claim that discontinuing SSRIs 💊 can be more challenging than overcoming heroin addiction, stating, "I know people, including members of my family, who’ve had a much worse time getting off of SSRIs than they have getting off of heroin." While antidepressants can lead to tolerance and withdrawal symptoms if stopped suddenly, THAT IS NOT THE SAME AS ADDICTION and drawing false equivalence with opioids is both wrong and incredibly damaging for people navigating depression.

He’s also gone on record suggesting a link between SSRI usage and violence, including school shootings. He asserted that "there's a tremendous circumstantial evidence SSRIs and benzos and other drugs are doing this." For the record, there is absolutely no evidence to support this.

Kennedy has proposed the establishment of "wellness farms" (they really thought farm was the right word to use?). These are government-funded facilities aimed at assisting individuals in discontinuing the use of psychiatric medications, including SSRIs. Instead, they would shift the focus to methods they label as more “holisitc” (groan… a word that has become a meaningless buzzword in mental health circles) such as farming, meditation, and skill development.

This should be seen in the context of a whole host of health related disinformation that he has supported over the years.

Are SSRIs overprescribed?

At the heart of the debate is the idea that antidepressants, while undeniably beneficial for many, are not a cure-all for mental health issues. Well duh. Antihypertensives aren’t a cure-all for hypertension and statins aren’t a cure-all for high cholesterol. However, it goes a step-further with claims that antidepressants are over-prescribed for intense, unpleasant but very human emotional states. The intent is seemingly to limit access to these medications as a way of tackling the perceived over-medicalisation of emotions.

SSRIs work for many people. They are an evidence-based, safe and useful tool for a range of medical conditions, including depression, anxiety, eating disorders and trauma-related conditions.

The question of whether selective serotonin reuptake inhibitors (SSRIs) are overprescribed has been a topic of extensive research and debate. A comprehensive 2018 systematic review and network meta-analysis (https://pubmed.ncbi.nlm.nih.gov/29477251/) assessed the efficacy and acceptability of 21 antidepressant drugs, including SSRIs, for the acute treatment of adults with major depressive disorder. The study found that all antidepressants were more effective than placebo, with odds ratios (ORs) ranging between 2.13 for amitriptyline and 1.37 for reboxetine. This indicates that SSRIs, among other antidepressants, have a statistically significant effect in reducing depressive symptoms compared to placebo.

There is little in the way of robust, reliable data on whether they are overprescribed - a question reliant on establishing whether the initial diagnosis is accurate and prospectively following up a large number of individuals to see if SSRIs led to clinically and statistically significant improvement. We nonetheless do know that there has been a global trend indicating a consistent increase in antidepressant prescriptions over the past two decades. This rise is observed across various countries and age groups.

“The Medical Model” vs. Biopsychosocial

This medical vs. psychosocial model nonsense is boring and outdated and those that continue to spout it are often those who question the legitimacy of mental illness. Again, nonsense.

Psychiatric treatment has evolved over time. Pre-1950s we had little in the way of medications to treat mental illness. The dominant theorists were psychoanalysts and treatment of severe and enduring mental illness generally involved institutionalisation in asylums, restraint and interventions considered barbaric by todays standards e.g. insulin shock therapy and lobotomies. Then we developed antidepressants and antipsychotics in the 1950s-60s and we became (with hindsight) far too beholden to the dopamine and monoamine hypotheses. It was then in the late 20th century that we brought the balance back to what we now refer to as the psychosocial model.

The Biopsychosocial Model was developed by George L. Engel, an American psychiatrist, in 1977 as a response to the limitations of the Medical Model. Engel argued that health and illness cannot be understood solely through biological factors but must also consider psychological and social influences. In his landmark paper "The Need for a New Medical Model: A Challenge for Biomedicine," Engel criticized the Medical Model for being too narrow. He proposed that:

• Health and illness are influenced by biological (genetics, brain chemistry), psychological (thoughts, emotions, behaviours), and social (relationships, culture, environment) factors.

• Medicine should shift from a disease-centered approach to a patient-centred approach.

This remains the approach that we treat many conditions today, but particularly mental illness.

What is the Solution?

The debate over antidepressant accessibility is far from over, and its implications extend well beyond the immediate discussions within political circles. It touches on fundamental questions about how society views mental health, the role of pharmaceuticals in our lives, and the importance of ensuring that every person has access to the care they need. However, limiting access to evidence-based treatment for mental illness is not the answer. If we improve access to meaningful, informed, accessible psychological support should come alongside the ability to access medication as a tool for treating illness. This either/or argument is flawed, archaic, and helps nobody.

Recommendations

Book: Fellow Travellers by Thomas Mallon

This is a historical novel set during the McCarthy era of the 1950s, a time of intense political paranoia in the United States. The book explores themes of love, secrecy, and political persecution, particularly in relation to LGBTQ+ individuals working in the government. As Hawk and Tim’s secret relationship unfolds, it becomes increasingly dangerous due to the Lavender Scare, a government campaign to purge homosexuals from federal jobs, seen as security risks. While Hawk is pragmatic and careful, Tim is deeply romantic and idealistic, making their affair emotionally intense and fraught with risk.

TV: Fellow Travellers

Its the TV version of the book but with Jonathan Bailey so… yeah. Need I say more?

Song: "Crawling" – Linkin Park

"Crawling in my skin, these wounds, they will not heal.” My inner emo kid has come out with this one.

Socials

Twitter (X): @elcarthy)

Instagram: @dr.elliott.carthy

TikTok: @drelliottcarthy (if it still exists…)

LinkedIn: https://www.linkedin.com/in/elliottcarthy/

Before you go…

I’d love to know if any of this resonated with you. Leave a comment if you’re comfortable sharing x

Do check out my reaction videos on antidepressants and whether you need to take them forever.

Please do share this with anyone you think would like it.