Experts push back as RFK Jr. compares SSRIs to heroin
Key Takeaways
Industry Buzz
“Misinformation about SSRIs can be harmful. Patients should rely on medical professionals for guidance, not political rhetoric.” — Laura Hack, MD, PhD, Director of Novel & Precision Neurotherapeutics at the Stanford Center for Precision Mental Health and Wellness
“Nowadays, maybe four to five kids out of 100 [are] on an SSRI. If you look in the adult population, that's more like 13%, 14%.” — Steven Siegel, MD, PhD, Chief Mental Health and Wellness Officer and Chair of the Department of Psychiatry at Keck Medicine of USC
Find more of your peers' perspectives and insights below.
The White House has pledged to assess the “threat” posed by the prescription of selective serotonin reuptake inhibitors (SSRIs) to children within the next 100 days.[]
The antidepressant medications have been a subject of interest for Robert F. Kennedy Jr., who has implied that the drugs are as addictive as heroin.[]
“I know people, including members of my family, who’ve had a much worse time getting off SSRIs than people have getting off heroin,” RFK said during his Senate confirmation hearings.
Experts say that his comparison between SSRIs and heroin is inaccurate. "This overstates SSRI risks, misaligning with evidence, and could deter needed treatment," Laura Hack, MD, PhD, Assistant Professor in the Department of Psychiatry and Behavioral Sciences and Director of Novel & Precision Neurotherapeutics at the Stanford Center for Precision Mental Health and Wellness, tells MDLinx.
“SSRIs can lead to discontinuation symptoms, sometimes called withdrawal-like effects, when stopped abruptly. This happens with many medications, including blood pressure medications and corticosteroids. A meta-analysis found that 20% to 50% of users experience symptoms like dizziness, ‘brain zaps,’ irritability, or insomnia after sudden cessation, lasting days to weeks. This reflects physical dependence—the brain adapting to sustained serotonin changes—not addiction,” says Dr. Hack.
How many children take SSRIs?
The executive order states that a commission will assess the prevalence of SSRI medication use among children, along with the “threat” posed by the drugs.[]
“Nowadays, maybe four to five kids out of 100 [are] on an SSRI. If you look in the adult population, that's more like 13%, 14%,” Steven Siegel, MD, PhD, Chief Mental Health and Wellness Officer at Keck Medicine of USC and Chair of the Department of Psychiatry and Behavioral Sciences at the Keck School of Medicine of USC, tells MDLinx.
The difference between dependence and addiction
Both Drs. Siegel and Hack emphasize that dependence on a drug does not equate to addiction.
“We have a whole host of medicines that address underlying illnesses that cause morbidity and mortality, and we are dependent on those medications to stave off the consequences of those illnesses. That's not addiction. So [Kennedy] should not—nor should we—conflate the need to remain on these medicines to stay well [with] somebody using heroin, [who] has no medical condition requiring the heroin,” Dr. Siegel says.
Dr. Hack says that as the Commission begins assessing SSRIs and other drugs, physicians should take steps to educate their patients about SSRIs.
“Physicians should emphasize [that] SSRIs are safe and effective when used appropriately. Close monitoring is key, especially for children and adolescents, [and] discontinuation should be gradual and medically supervised. Misinformation about SSRIs can be harmful. Patients should rely on medical professionals for guidance, not political rhetoric,” Dr. Hack adds.
These are lifesaving medications
Both Drs. Hack and Seigel note that SSRIs can be appropriate for children when clinically necessary. For some people, they note, the medications can be life-saving, and restrictions on the drugs could have severe consequences.
“We have many classes of mental health medicine that are nothing short of life-saving miracles for people with major mental illness. And if any of those medications were to be withheld from the public, it would be a real tragedy […] of both justice and provision of what many of us would call a basic human right and access to appropriate care,” Dr. Seigel says.
“We see [Kennedy] and others advocating for limiting access to vaccines that literally save lives … with [either] a fundamental […] misunderstanding of science or disregard for the welfare of our population,” Dr. Siegel adds. “Just as withholding or decreasing access to the measles vaccine will lead to more cases of measles and measles deaths, withholding or obstructing access to mental health medications will cause morbidity and mortality.”