Robert F. Kennedy Jr. is now dealing with anti-depressants as part of his Make America Healthy Again (MAHA) nonsense.1 He claims that antidepressants are over-prescribed and dangerous. He wants to be described. And while it would be great if people didn’t need to take antidepressants — or any other drug for that matter — antidepressants are life-saving and health-creating drugs for many. So, let’s take a look at the facts behind antidepressants and the violence, danger, and overprescribing.
RFK Jr. states antidepressants. they are dangerous, over-prescribed and cause heroin-like withdrawal
It’s no surprise to anyone that Kennedy is aiming to get off the anti-depressants. He has tried to link them to school shootings and violence for years:
“You know, a lot of them … have black box warnings that warn of suicidal ideation and homicidal ideation. So we need to — we can’t rule them out as guilty.”
He has also stated that Antidepressants are harder to get off than heroin:
“I know people, including my own family members, who have fared worse on SSRIs than people who had stopped heroin.”
Furthermore, he feels they are over-prescribed, as he states in his recent report Health and Human Services (HHS) Statement.:
“Today, we are taking clear and decisive action to address our nation’s mental health crisis by addressing the overuse of psychiatric medications – especially among children.”
Of course, he is also the person who snorted cocaine off toilet seats and eats roadkillso not sure why anyone is taking health advice from this guy.
But, of course, people do. He is the Secretary of Health and Human Services, after all. So let’s take a look at his claims.
Antidepressants and school shootings and violence
First of all, let’s be clear, black box warnings on antidepressants they contain no warning of homicide. Suicidal ideation in youth (under 24), yes, but homicidal ideation, no.
Plus I could pull up 1000 quotes of psychiatrists talking about how antidepressants don’t cause violence or school shootings. But instead, I’d rather look this evidence-based article written by doctors. This is not an unconsidered question.
They have some clear messages about antidepressants and violence:
- Enhancement of serotonergic neurotransmission reduces aggressive behavior in humans.
- “[There is] there is no conclusive evidence linking the use of fluoxetine [Prozac] or other SSRIs with violent or suicidal behavior. . . In contrast, there is considerable evidence from the past decade to suggest that fluoxetine may be associated with improvements in anger and aggression toward both self and others.”
- “…significant reduction in fatal violence over 15 years of increased SSRI exposure in the community [was reported] . . .”
They also make the very good point that “such narratives [around violence and criminal behavior] promoted via the internet and social media as a result of confirmation bias, lack of awareness of prevalence and misunderstanding of how FAERS [the US Food and Drug Administration Adverse Event Reporting System] factory.”
This is not to say that antidepressants are not associated with an increase agitation or even attack in some cases; However, this is a far cry from violence or, say, a school shooting. (The article above says that caution is needed when prescribing antidepressants to those already predisposed to violence, especially youth. Fair enough.)
Antidepressants and Difficult Withdrawal
Traditionally, it was believed that antidepressants do not cause withdrawal symptoms. I would say that it is clear that this is wrong. Many antidepressants cause withdrawal, and some, like venlafaxine and desvenlafaxine, can really be hell. (However, there are techniques that make this easier.) However, many people take antidepressants with little to no withdrawal.
I would argue that withdrawal from antidepressants is a far cry from heroin withdrawal. however, as opiate withdrawal it can actually kill you.
Antidepressants are overprescribed
Here, there is an argument to be made. Many doctors would say that antidepressants are over-prescribed and under-prescribed. Let me explain.
An antidepressant such as fluoxetine can be prescribed for many conditions, including:
- Major depressive disorder
- Eating disorders
- Anxiety disorders
- Obsessive compulsive disorder
- Premenstrual dysphoric disorder
- Fibromyalgia
- Post-traumatic stress disorder
Most of these uses are approved by the Food and Drug Administration (FDA), while some are off-label. However, if you add up all the people in society who have all these disorders, you get quite a few.
That said, some doctors would argue that we are moving too quickly to prescribe antidepressants when other treatments may also be effective. For example, various forms of psychotherapy are highly effective in treating many of the above disorders and only Prescribing drugs is unfair to patients.
However, if there’s one thing patients need access to and don’t have, it’s psychotherapy. And if you’re a doctor with a distressed and sick patient in front of you, you can often get them effective medication rather than psychotherapy, no matter how much they might benefit from the latter. This may technically be “overprescribing,” but it’s also harm reduction.
However, many people with mental illness, especially severe mental illness, do not even have access to medication.
As noted here:
“Nearly two-thirds of Americans with a diagnosed mental health condition were unable to access treatment in 2021, even though they had health insurance. And only one-third of insured people who visited an emergency department or hospital during a mental health crisis received follow-up care within a month of being discharged.”
So while some people on antidepressants may be well served by other treatments, many who desperately need treatment of any kind cannot get it. That makes Kennedy half right, I guess.
I’d rather have people on anti-depressants who could use other treatments but can’t take them than not take them at all, but that’s me.
Should doctors prescribe antidepressants because of risk and violence?
Should doctors prescribe antidepressants? Yes. Should doctors prescribe antidepressants because of fear of danger and violence? No. Weaning a patient off a drug such as an antidepressant is a physician’s duty, but only in appropriate cases, and those cases should not be determined by fear. The problem with what Kennedy is doing with his misleading statements and outright lies is that he is instilling fear that will undoubtedly cause people to demand the description even in cases where it shouldn’t be. Decisions will be made with fear instead of science. This is the wrong way to do medicine, period.
If you feel that you want to stop your antidepressant, you should definitely discuss this with your doctor. You should also make a plan and be supervised if it is safe to do so. But you should also recognize that staying on your medication may be, by far, the safest and healthiest thing for you. And Kennedy is not qualified to tell you otherwise.
