The Truth About Antidepressant Withdrawal Symptoms

Jul 23, 2025

In this conversation, Dr. Mark Horowitz, a psychiatrist and researcher specializing in medication withdrawal, shares his firsthand insights into the complexities of antidepressant tapering. He argues that current clinical guidelines severely underestimate the intensity of withdrawal symptoms, leading many patients to feel gaslit. Dr. Horowitz clarifies the critical distinction between withdrawal and relapse, highlights the need for improved research methodologies, and advocates for a more personalized approach to depression treatment, emphasizing the importance of lifestyle changes.

Ask episode

AI Snips

Chapters

Transcript

Episode notes

ANECDOTE

Mark Horowitz's Withdrawal Experience

Mark Horowitz experienced severe withdrawal symptoms including panic attacks and akathisia when tapering off antidepressants, contrary to medical guidelines stating withdrawal is mild and brief.
His personal ordeal led him to research and advocate for better understanding of withdrawal in psychiatric medication.

INSIGHT

Duration Worsens Withdrawal Effects

Withdrawal symptoms are more severe and long-lasting with longer antidepressant use, similar to how a heavy rock sinks deeper into muddy water over time.
Current guidelines underestimate withdrawal because they rely mainly on short-term studies, ignoring real risks for long-term users.

INSIGHT

JAMA Study Limited to Short-Term Data

The new JAMA meta-analysis largely reaffirms previous findings based on short-term studies that antidepressant withdrawal is mild and brief.
However, it excludes important longer-term studies where withdrawal symptoms are more severe, thus providing an incomplete picture.

Get the Snipd Podcast app to discover more snips from this episode

Get the app

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.