Mark Horowitz @markhoro.bsky.social @markhoro
Associate Professor in Psychiatry (AdelaideU). Maudsley Deprescribing Guidelines: https://t.co/MdD00qaw2z (US) https://t.co/9eUVpPjCRX (UK) markhorowitz.org London Joined April 2013-
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Was good to lecture today to 700 clinicians for the US Substance Abuse and Mental Health Services Administration @samhsagov about withdrawal and deprescribing along with Matthew Rudorfer, head of psychopharm research at NIMH, and Laura Delano with her affecting story
"Why Doctors Don’t See Withdrawal" Written by Dr. Mark Horowitz ARTICLE LINK: mhorowitz.substack.com/p/why-doctors-…
After stopping antidepressants, this 23-year-old said she experienced a “chemical castration." What to know about PSSD, according to experts. usatoday.com/story/life/hea…
"Suicidal thoughts: Placebo: 2 (1.5%) Lexapro: 13 (9.5%) If this had been efficacy data, AbbVie would have been ecstatic - that difference is dramatic. Unfortunately for the kids, it’s in the direction of killing yourself."
You are arguing with a certainty that is not merited. The 200,000 people on withdrawal groups are not there because they had mild symptoms - they are there because their lives have been turned upside down. It is not credible to say that 5-15% of long-term users have withdrawal. It is difficult to talk to someone who is so blinkered and biased that they keep calling me biased and occasionally throwing fits. Here is an double blind RCT in people on the drugs for 11 months where 60%+ of users have 4 or more withdrawal effects after stopping: pubmed.ncbi.nlm.nih.gov/9646889/. If you are presenting Henssler as your evidence then I think you should be serious and not use short term trials not set up to look for withdrawal as your evidence. Of course that is hugely biased. Of course you are minimising things. I didn't say it was because you were paid by drug companies.
I hear stories like this daily. Countless thousands of people see doctors who were never taught about psychiatric drug dependence and withdrawal and were trained instead to see worsening problems upon stopping meds as the “underlying condition.” The tide is now turning.
After being rapidly tapered off 150mg of sertraline following 14 years of use, this is what I faced from GPs and psychiatrists. Most of them initially refused to acknowledge antidepressant withdrawal, repeatedly misdiagnosed me and through their responses, caused significantly
Long-term use of antidepressants: little evidence of benefit and growing evidence of risks, including sexual dysfunction, emotional numbing, cognitive impairment, weight gain and increased risk of physical health problems in older adults.
What's that saying about an ordinary group of citizens and putting the world to rights? Is it something like 'when pharmacovigilance is not fit for purpose and professional institutions are more concerned with prestige than safety it will be left to harmed patients to do their job for them'? Something like that.
Happy to be invited by the Municipality of Dropull in Albania to speak about medication safety and patient protection. We will discuss safe medicine use, adverse effects, withdrawal symptoms, and the importance of informed healthcare decisions.
From Adelaide University "Fresh concerns have been raised over long-term use of antidepressants, with a new summary of evidence revealing limited benefits and higher health risks, prompting calls for treatment reviews every six months." Link below.
Glad to see the Royal Australian College of General Practice @RACGP taking the issue of stopping antidepressants seriously in their journal @ajgp. Link below. There is a lack of evidence for the long term use of antidepressants because the discontinuation trials used to support this are flawed (they ignore withdrawal effects) but there are significant harms to long-term use. GPs need to review patients on long term treatment and help people to stop when the harms outweigh the benefits, which is true for many of the millions of patients on these drugs long-term.
Very pleasant to watch a psychiatric leader grapple with all the right sort of questions. A nice change of pace.
Nice to hear hopeful (sort of) stories. Ignorance is one thing, but recalcitrant resistance to learning is something else (not in this doctor).
I had a severe protracted withdrawal off Lexapro because my dr recommended a linear taper. I actually think she's an incredible dr and just didn't know better. I shared hyperbolic tapering info w/ her after my WD and she thanked me. Hope to see more provider convos like this.
This blog deconstructs the debate over antidepressant withdrawal in a sympathetic way that highlights why doctors are primed to underestimate it. mhorowitz.substack.com/p/why-doctors-…
An illustrative comment from the piece: "I remember the hopeless[ness] of seeing doctors, but a need for care. In one appointment the gp said “you can come off ad’s, I came off mine. I reduced, skipped a day and …oh yes I developed awful palpitations so had to go back on them”.
I wrote a blog on "Why Doctors Don’t See Withdrawal: Severe antidepressant withdrawal is often hidden in plain sight. Here's why most clinicians don't recognise it – and why I wouldn't have either until it happened to me." Link below. Please re-tweet.
This is a common refrain from prescribers - because they have been taught withdrawal is 'mild and brief' which is re-iterated by academics deliberately focusing on unrepresentative samples - so naturally this sort of misdiagnosis will happen and be experienced as gaslighting from patients.
@RecoveryDoctor @markhoro @iatrogenicaware No wonder you think withdrawal is rare. My former psychiatrist said all the symptoms I had only when he took me off cold turkey from my medication “couldn’t possibly be from withdrawal”.
I am sure you understand that 'we need better data' is the oldest way in the book to avoid what is a massive problem whether it is 5% or 15%. And I am sure you don't get paid for your work which is reliant on a certain system of understanding. Your ad hominem attacks are a very weak refuge.
I think there has been a lot of "discomfort" on this platform recently from some very fragile men.
When you disagree with someone’s ideas, you engage the argument. When you attack their character, question their motives, or assign malicious intent, you often reveal more about your own discomfort than about them.
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