The annual meeting of the American Psychiatric Association came just ten days after Health Secretary Robert F. Kennedy Jr. announced HHS policies encouraging doctors to deprescribe psychiatric drugs, especially, antidepressants. This was a topic of many casual conversations among the psychiatrists at the meeting in San Francisco, where the recently published Stahl’s Deprescriber’s Guide was selling well.
Dr. Chris Aiken, a psychiatrist and editor-in-chief of The Carlat Report, an independent source of clinical psychiatry advice, gave a presentation titled “The Much Too Medicated Patient: Rational and Irrational Polypharmacy”, deprescribing unnecessary psychiatric polypharmacy. Aiken’s session was standing-room only.
His session was part of a wave this year devoted to deprescribing — among them “Deprescribing Antipsychotics: Why When How”; “Deprescribing Antidepressants and Mood Stabilizers, Why When How”; and “Stimulants for ADHD: Did We Get It Wrong? Questioning the Sustainability of Stimulants for Life”.
In remarks to the New York Times, Aiken pointed to a generational shift underway within the association, as physicians in their 30s and 40s take on a more prominent role and bring a heightened awareness of poor long-term outcomes in their generation.
“Meds are not the answer, and they have seen this in their own lives,” Aiken told the Times. (Later, on social media, he maintained that he had said, “Meds are not the answer to all life’s problems”.) Of antidepressant withdrawal difficulties, he said, “I don’t really know how common it is, but I do know that when it does happen, it can be quite severe…. It may be rare, but let’s take it seriously, because it can really burn people when it happens.”
At the end of his talk, Aiken made sure to present his final slide, a recommendation of the gradual Horowitz-Taylor hyperbolic tapering method. Mark Horowitz is an advisor to the Psychotropic Deprescribing Council.
References
Horowitz, M. A., & Taylor, D. (2019). Tapering of SSRI treatment to mitigate withdrawal symptoms. The Lancet Psychiatry, 6(6), 538–546. https://doi.org/10.1016/S2215-0366(19)30032-X
Strawn, J. R., & Stahl, S. M. (2026). Stahl’s Deprescriber’s Guide. Cambridge University Press. Cambridge Core. https://www.cambridge.org/core/product/0D15AD0C2887CF22ADCD95643A66D7B2
