RFK and SSRIs: Trouble Ahead.

by Mandy Morgan February 18, 2025

Robert F. Kennedy Jr.’s recent confirmation as Secretary of Health and Human Services (HHS) has sparked widespread debate, particularly regarding his views on selective serotonin reuptake inhibitors (SSRIs). Long known for his skepticism toward vaccines and pharmaceutical interventions, Kennedy has now turned his attention to antidepressants, calling for a federal review of their prescription rates and potential risks. But how much of his rhetoric aligns with scientific evidence, and what does this mean for public health policy?

Kennedy’s Claims About SSRIs and Withdrawal

Selective serotonin reuptake inhibitors (SSRIs) are a class of medications commonly prescribed to treat depression, anxiety, and other mood disorders. They work by increasing levels of serotonin, a neurotransmitter that helps regulate mood, by preventing its reabsorption in the brain. This can help improve symptoms of depression and anxiety over time. Some of the most commonly used SSRIs include fluoxetine (Prozac), sertraline (Zoloft), paroxetine (Paxil), escitalopram (Lexapro), and citalopram (Celexa).

Kennedy has claimed that SSRIs, widely prescribed to treat depression and anxiety, may be overprescribed and potentially addictive. During his confirmation hearing, he went as far as stating that some people find it harder to stop taking SSRIs than to withdraw from heroin—an assertion that has drawn both criticism and scrutiny.

While it is true that some individuals experience SSRI discontinuation syndrome, characterized by flu-like symptoms, dizziness, nausea, and headaches, the severity of withdrawal varies depending on the specific medication. Research shows that about 7% of users of short-acting SSRIs, such as paroxetine, experience withdrawal symptoms, compared to 2% of those on long-acting SSRIs like fluoxetine. In cases where people stop SSRIs abruptly, discontinuation symptoms can occur in up to 40% of users. However, these symptoms are usually temporary and can be managed by gradual tapering under medical supervision.

Comparing SSRI Withdrawal to Heroin Withdrawal

Kennedy’s comparison between SSRI withdrawal and heroin withdrawal is (surprise) misleading. While both can be challenging, opioid withdrawal is far more severe and physically dangerous. Approximately 85% of heroin users experience severe withdrawal symptoms, which can include extreme cravings, nausea, diarrhea, fever, increased heart rate, and long-lasting psychological distress. Withdrawal from opioids often requires medication-assisted treatment (MAT) with methadone or buprenorphine, while SSRI discontinuation can typically be managed by dose tapering or switching to a long-acting SSRI like fluoxetine.

Although some people struggle to stop taking antidepressants, SSRIs are not classified as addictive by the medical community. Unlike opioids, they do not produce cravings or compulsive drug-seeking behavior. The nocebo effect, where patients develop withdrawal symptoms due to negative expectations, may also contribute to discontinuation challenges.

What This Means for Public Health

Kennedy’s stance on SSRIs could have significant implications for mental health treatment and policy. With nearly 13% of American adults relying on these medications for depression and anxiety, any efforts to restrict access or stigmatize their use could lead to negative mental health outcomes.

Public health experts caution that Kennedy’s rhetoric may reinforce misconceptions about antidepressants, discouraging people from seeking necessary treatment. While overprescription is a valid concern, the focus should remain on evidence-based prescribing practices rather than alarmist narratives.

As Kennedy moves forward with his plans at HHS, the public health community must remain vigilant in ensuring that science—not ideology—guides mental health policy.

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