Does psychiatric medication withdrawal exist — or is it just a myth?

For anyone who’s lived through it, the question alone can feel insulting.

Psychiatric drug withdrawal is real. While the experience varies widely, for many, it’s not “brief and mild” as many guidelines state it is. It can be intense, destabilizing, and often misunderstood. One of the most painful challenges is trying to determine whether what you're experiencing is withdrawal or relapse.

Unfortunately, current clinical guidelines don’t help. They often frame withdrawal as short-lived and minor, dismissing anything more severe as a return of illness. A potentially dangerous oversimplification that can leave patients feeling gaslit or unsupported.

In this interview, Dr. Mark Horowitz, a psychiatrist and researcher who’s both studied and experienced withdrawal firsthand, unpacks a new JAMA study that exemplifies the problem: guidelines built on inadequate evidence.

In this episode, you’ll hear:

• Why current drug withdrawal guidelines fall short
• Overview of the new JAMA paper Incidence and Nature of Antidepressant Discontinuation Symptoms
• The critical distinction between withdrawal and relapse
• The truth about psychiatric drug withdrawal
• How to design better research that reflects real-world experiences
• Why this information is often not reaching clinicians
• How we can conduct research that can better inform patient support

Dr. Horowitz’s story is one of courage and insight. As a clinician, he had no idea how wrong the guidelines were, until he tried coming off medication himself. What he discovered was far more complex than anything he’d been taught.

To those navigating psychiatric medication withdrawal — especially in the face of oversimplified headlines and a healthcare system not yet equipped to support you — our hearts go out to you. You deserve care that is informed, compassionate, and grounded in lived experience as well as science. We won’t stop until you have this.

Expert Featured:

• Dr. Mark Horowitz
• X: @markhoro
• Website: https://markhorowitz.org/

Resources Mentioned:

Incidence and Nature of Antidepressant Discontinuation Symptoms A Systematic Review and Meta-Analysis

• https://jamanetwork.com/journals/jamapsychiatry/article-abstract/2836262

3 Long-Term Psychiatric Medication Studies

https://www.biologicalpsychiatryjournal.com/article/S0006-3223(98)00126-7/abstract

https://journals.lww.com/intclinpsychopharm/abstract/2002/09000/discontinuation_symptoms__comparison_of_brief.2.aspx

https://www.cambridge.org/core/journals/the-british-journal-of-psychiatry/article/interruption-of-selective-serotonin-reuptake-inhibitor-treatment/F0241958CB073C51F366E2AABE636B5D

Outro Clinic

https://www.outro.com/

The Maudsley Desprescribing Guidelines: Antidepressants, Benzodiazepines, Gabapentinoids and Z-drugs

https://www.amazon.com/Maudsley-Guidelines-prescribing-Prescribing/dp/111982298X

CMEs Mentioned:

https://www.metabolicmind.org/for-clinicians/trainings-courses/

Follow our channel for more information and education from Bret Scher, MD, FACC, including interviews with leading experts in Metabolic Psychiatry.

Learn more about metabolic psychiatry and find helpful resources at https://metabolicmind.org/

About us:

Metabolic Mind is a non-profit initiative of Baszucki Group working to transform the study and treatment of mental disorders by exploring the connection between metabolism and brain health. We leverage the science of metabolic psychiatry and personal stories to offer education, community, and hope to people struggling with mental health challenges and those who care for them.

Our channel is for informational purposes only. We are not providing individual or group medical or healthcare advice nor establishing a provider-patient relationship. Many of the interventions we discuss can have dramatic or potentially dangerous effects if done without proper supervision. Consult your healthcare provider before changing your lifestyle or medications.