Culture Apothecary with Alex Clark - Step-by-Step Guide to Getting Off Antidepressants 💊 | Dr. Josef Witt-Doerring, MD
Episode Date: April 11, 2025What if antidepressants aren’t the answer, but the cause of your struggles? 😳💊Dr. Josef Witt-Doerring, a board-certified psychiatrist, former FDA medical officer, and co-founder of TaperClinic..., is here to shatter the myths around psychiatric meds and withdrawal. With years of experience in drug safety and mental health, he’s on a mission to help you safely taper off and take control of your mental health—without the brain zaps and emotional chaos. 😤✨If you’re tired of being stuck in the medication cycle, this episode is your wake-up call. It’s time to take back your peace and well-being. 💪💚Thank you to our sponsors! 😊Taylor Dukes Wellness | Use code "ALEXCLARK" for 10% OFF Active Skin Repair | code 'ALEX' 20% OFFCozy Earth | Use code "ALEX" for 40% up to OFFMasa Chips | Use code "REALALEXCLARK" for 20% OFFUtzy Naturals | Use code "ALEX” for 20% OFF Our Guest:⭐️ Dr. Josef Witt-Doerring, MDTaperClinic WebsiteTaperClinic Sign Up Dr. Josef's YouTube Channel TaperClinic Instagram TaperClinic TikTokFavorite Book | 'Anatomy of an Epidemic' by Robert WhitakerTop Tip | Treat problems at their root cause. Sustainable recovery starts with truth and resilience.🎀Follow Alex🎀Instagram |@realalexclarkInstagram |@cultureapothecaryFacebook |@realalexclarkX |@yoalexrapzYouTube |@RealAlexClarkSpotify |Culture Apothecary with Alex Clark Apple Podcast |Culture Apothecary with Alex ClarkNew 'Culture Apothecary' Merch OUT NOW! Glass tumblers, weekly wellness planners, hats, crewnecks and more. Use code "Alex Clark" for 10% OFF at tpusamerch.comJoin the Cuteservatives Facebook group to connect with likeminded friends who love America and all things health and wellness! Join the CUTEservative Facebook Group!Subscribe to ‘Culture Apothecary’ onApple Podcasts and Spotify. New episodes drop 6pm PST/ 9pm EST every Monday and Thursday.This show is made possible with generous donations from listeners who believe in our mission to heal a sick culture.You can support our show by leaving a tax deductible donation HERE or by subscribing to @RealAlexClark YouTube for FREE!#CultureApothecary #AlexClark #MentalHealthMatters #TaperOffMedications #AntidepressantAwareness #MentalHealthJourney #DepressionAndAnxiety #HolisticHealing #FunctionalMedicine #DrugSafety #BrainZaps #TaperClinic #SSRI #Antidepressant
Transcript
Discussion (0)
There have been no clinical trials with Cibo controls, active controls of any sort,
where you can see what these drugs are doing past a year.
There is widespread belief that SSRI's cure depression.
We've had like three decades of marketing tell us that anxiety and depression are due to chemical imbalances.
We have never found that.
How do you feel as a psychiatrist about primary care physicians being some of the main people
prescribing, you know, antidepressants to people?
I think it's malpractice.
Are you currently on an antidepressant and wondering what the risks really are,
where maybe you're struggling to taper off and finding it almost impossible due to brain zaps,
physical discomfort, or emotional turmoil?
If you're feeling stuck in the cycle of medication, this is an episode you absolutely can't miss.
Today, we're joined by Dr. Joseph Whitoring, a board-certified psychiatrist, drug safety expert,
and the co-founder of Taper Clinic, the largest psychiatric deperscribing practice in the United States.
With a background as a former FDA medical officer and a consultant to the pharmaceutical industry,
Dr. Joseph has an unmatched understanding of psychiatric medication safety, the risks involved
with withdrawal, and the often overlooked issues in conventional mental health treatment.
His mission is to help people safely and effectively taper off psychiatric medications,
all while improving their overall health through functional medicine and holistic therapies.
In this episode, we dive deep into the science behind antidepressants, the realities of withdraw,
and explore how you can regain control of your mental health,
whether you're trying to get off medication
or just want to better understand its effects.
Watch this episode on the Culture Apothecary Spotify
or Real Alex Clark on YouTube,
and don't forget, we are completely donor-funded,
so if you love this show and you want to see its continued success,
consider gifting a tax-deductible donation through the link in the show notes,
or, as always, you can leave a five-star review for free.
Find new friends and continue the discussion after the episodes
in the Cute Servatives Facebook group or Culture Apothecary on Instagram.
Please welcome psychiatrist Joseph Witt Doring, co-founder of the Taper Clinic to Culture Apothecary.
You call yourself a psychiatric deprescriber.
What is that?
So I'm someone who specializes in helping people come off psychiatric medications.
How unpopular is that in psychiatric circles?
I would say massively needed for the people on the medications, but for the doctors out there who aren't doing this, it makes them uncomfortable.
and so it becomes unpopular.
Why would that make a doctor uncomfortable people getting off medications?
Wow. So I think it goes to the heart of what a big problem is in psychiatry these days.
And it is that we have a very transactional way of helping people with mental health problems,
which is obviously broken.
And I think a lot of people, doctors included, have started to pick up on that.
I mean, the common experience for many people out there is they'll go in and see a family doctor or a psychiatrist.
They'll see them for maybe half an hour.
They'll get diagnosed sometimes with just a checklist of symptoms, and they'll get started on a medication.
The doctor seldomly spends much time talking about non-drug approaches to helping people,
whether it's dietary interventions, exercise, targeted therapies for things like relational problems or problems.
with, you know, work, and they just put them on medications.
And that's really how the mental health system functions these ways.
A lot of doctors out there have kind of just sort of rationalized to themselves that,
hey, this is just how we do things these days.
It's an insurance-based practice.
We don't have a lot of time.
This is just the way we have to treat people.
But I don't accept that.
And, you know, a lot of people that you've spoken to on your show like Kim and Roger and other
people, they think the system's broken and so do I. And so I think when someone like me comes out
and is talking about overprescription problems that we need to be doing much better in mental
health, it makes people uncomfortable because they say, I don't want to change. You know, I've
already sort of rationalized to myself that this is just the way that we need to do things. And so
I cop a lot of flack for that. People feel very uncomfortable. Have people tried to shut down your
ability to practice? Yeah. Yeah. So we get comments on our, on our social media and it's just
like, if anyone else here is unhappy about what he's saying, here is the email address for the Utah
Medical Licensing Board, you know, go ahead, file a complaint against Dr. Whituring.
And so we got a lot of that.
I guess that's, you know, that's just the way it is when you're out there talking about
inconvenient truths.
As a psychiatrist, which drugs do you believe are responsible for an uptick in anxiety and depression?
What I've been seeing a lot of is actually non-prescription drugs.
And so things like caffeine, I mean, we have situations these days where because we live a much more sedentary lifestyle, you know, people will sit behind the computer and work all day and they'll drink three cups of coffee or they'll be dipping or using like zen pouches or something like that.
And they're not moving their body.
And then they start to feel really anxious.
And so I think that's a big problem.
I feel like we feel like we always need to be so on
that we can sort of work ourselves up
into these big sort of anxious states.
So that's one part of it, which I think is really concerning.
The other is cannabis use.
Cannabis is way stronger than what it used to be.
You know, at least when I was experimenting with cannabis,
smoking some cannabis when I was growing up,
I see that get people really sick,
and not just anxious, like sometimes psychotic.
And so I'd say those,
those drugs definitely make people more anxious.
Well, the marijuana conversation is a fascinating one to me because we hear that a lot,
especially from a lot older generations.
They say, like, man, the stuff you guys are smoking is so different than what I smoked,
you know, when I was in college or whatever.
And I feel like it has something to do with like, we've totally commercialized that
business by legalizing it.
And they're growing it cheaper.
They're spraying it with all sorts of chemicals.
Like the stuff that we're spraying on weed today is different than what they were using before as well.
And so you're really just smoking a ton of chemicals.
I don't think people realize that they think it's just a plant.
So it's just a plant.
But it isn't.
Today's weed is not the same.
It's basically like what we've done to marijuana is like what we did to ultra-process food.
Yeah.
Yeah.
And I mean, cannabis is a big industry.
I mean, over the last 10 years or so, it's just been becoming, you know, either medically legal or fully recreational.
legal in different states in the US. And so we have a big cannabis industry right now that does what
we see in pharma, where the messaging is essentially to kind of overhype the positive aspects of it.
Oh, it's great for PTSD. It's great for pain. You know, it's safer. And they don't talk about the
risks of it either. And so I also think that the perception of cannabis being this really harmless
thing has been completely skewed now where people don't recognize that there's actually a lot of
harm to it and I mean get stronger and stronger and stronger um I think usual like weed used to be like
one to two percent THC you have like dabs and shatter and these different like ultra concentrated forms of
it that are like 40 percent holy smokes yeah yeah so much more and there's even synthetic types of
THC and different chemical compounds like spice or k2 which go even higher than that this is actually one
of the ways that I see people enter the psychiatric industry and become a permanent mental health
patient.
You're kidding me.
Well, you know, everybody is so adamant who smokes weed.
They're like, it's not addictive.
But the first time you post anything that's, you know, at least, that's even minimally
critical about marijuana on X, for example, all of your replies are all these people, like,
freaks in this marijuana cult being like, oh, it's not addictive.
Like, I'm like, who reacts his way?
Like, you only see that when you talk about podcast.
You know, these people, it's like they have to take a hit, you know, every so often throughout the day.
You know, I can't wake up without it. I can't go to sleep without it. I'm like, that is literally addiction.
Yeah. It is addiction, but I think a lot of people lie to themselves and say, it's my medicine.
You know, it's my medicine for anxiety. It's my medicine for pain. But then they're smoking like ultra high potency, THC, and then they get stuck on it and they can't come off.
And I want to, you know, I'll be a little sensitive here because I know that a lot of people really.
campaigned for the legalization of this. And maybe, and, you know, there are some use case scenarios.
Like if someone is smoking pot and they're not taking oxycodone or something like that,
hey, that's okay. You know, if someone's using pot for, you know, terminal cancer, that's okay.
And we shouldn't be putting up barriers for these people. We have to just realize that it's gone
too far. And we need to be aware of just how risky this is. And it's not that big of a deal if you
are someone who is like 30 and your central nervous system has fully matured, you're much less
likely to have serious problems. But we have like, I mean, the group that picks it up the most are
like 16 to 25. I mean, these are young people. They're way more susceptible to the harms of it.
They're more likely to get addicted. They're more likely to have cognitive problems and actually
to develop like a psychosis from it. And oftentimes I will see people who I take off antipsychotics,
who've been diagnosed with bipolar or schizophrenia.
And when you take the history,
they started smoking a lot of pot
when they were in their late teens or early 20s.
They have a psychotic disorder.
They become psychotic.
And people don't understand.
The cannabis is so strong these days
that even two weeks after this
and when the drug is out of your system,
you can still be reeling from a cannabis-induced psychosis
because it's not just the drug that's like in there
that's making the person's psychotic, it's almost like they've had like a concussion from it,
like they've had an injury. You can have paradoxical bad reactions to all sorts of drugs.
So to cannabis or psychiatric ones. A lot of people have seen this. You know, you have like 10 people
sitting around. Nine of them are giggling from the cannabis and one person's like very self-conscious.
I'm the one person. Let me tell you right now. Yeah. I like I was somebody that would like do that
occasionally if somebody had it at like a social get-together or whatever in my like early to mid-20s.
And it was never fun for me. And I finally, in like my late 20s, I was like, you know what, I don't like this. I don't know why I accept it. I don't have to. And I was like, I just made a decision one day. I was like, I'm never doing this again. I've never enjoyed it. I always felt extremely paranoid. Like just, it wasn't fun.
So you would have been the type of person that if you were exposed to like super high strength
cannabis, if someone's like, hey, Alex, let's do some dabs, something like that, you might
have had a psychotic reaction to it, which would have, I think it's actually neurotoxicity.
And so when someone who is sensitive to it gets exposed to this really high potency THC,
I've seen people have a psychosis and not feel like themselves for like months afterwards,
sometimes up to a year.
And doctors will miss this.
They'll say, no, you know, you've smoked cannabis.
You're still having some psychosis.
But, you know, really we expected this to go away within one to two weeks of stopping the drug.
And if it's still there, instead of them seeing it, like, you know, you took a hit to the nervous system because you're susceptible.
They'll say, you have schizophrenia.
And then they end up putting someone on antipsychotics.
If you actually are somebody who doesn't truly have schizophrenia and you were put on schizophrenia medication, what can that do to the brain?
I can do a whole range of things. I mean, antipsychotics are some of the most toxic psychiatric meds from a safety perspective. I mean, there's always a use case scenario for some of these things. But in general, the things we worry about with antipsychotics is they can cause permanent movement disorder, quartarative dyskinesia. That occurs at an incidence of like 5% per year. So the longer you're on it for the more likely you are to experience that.
Most people are familiar with this from the Batman movies with the Joker.
And if you sort of remember what he looks like, his tongue is like popping out of his mouth.
His lips are moving.
And that's because he's spent so much time in like Arkham Asylum, where he's been given antipsychotics.
And so they start to look like the Joker.
They have involuntary mouth movements.
And that does not go away.
Oh, my gosh.
And so you have that.
Cognitive decline correlates with that as well.
So people will, they won't be as sharp and it actually causes brain shrinkage as well.
I mean, they've done terrifying animal studies where they would grab McCore monkeys
and they would put them on haloperidol and olanzapine, which are antipsychotic medications.
And it shrinks their brains.
You know, when they look at the size of the monkey brain afterwards, it's like 15% smaller.
And so, I mean, these things are sort of terrifying.
So you really want to get the diagnosis right if you're going to use a medication like this.
I mean, we're missing things like cannabis-induced psychosis and needlessly putting folks on these drugs.
We put people on serriquil to help them sleep.
That's like another sedating antipsychotic.
And there's heaps of people out there that take cerebral for sleep, not being aware that they're on an antipsychotic.
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There is widespread belief that SSRI's cure depression.
What is the scientific consensus on whether or not SSRI is actually cure depression?
I think we've had like three decades of marketing tell us that anxiety and depression are due to chemical imbalances or genetic problems in our brain.
We have never found that.
This was just a marketing spin that was put out there.
And researchers have gone and they've collected all of the data together.
And there's no chemical imbalance there.
So there's no unifying cause of depression.
That's why we don't use tests in psychiatry.
That's why when you go and see a doctor, even if you go to like Harvard or Yale or, you know, one of these big tertiary medical centers, no one's scanning your brain or measuring like the neurotransmitter metabolites because it just doesn't correlate to anything.
So, and that's important because when we think about what an antidepressant does is they disrupt your neurotransmitter systems.
So like SSRIs, they block serotonin reuptake to increase the amount of serotonin between the neurons.
That's not actually fixing any underlying problem because an underlying problem like that has never been found for anyone.
Well, one of my favorite things, every single time I talk about SSRIs and antidepressants and how they're basically placebos and they don't do anything.
You know, people in my replies are like, how dare you an antidepressant save my life?
I have a chemical imbalance in my brain.
And my response to them always is, oh, really, how did they test for that?
What was the test like to test for your chemical imbalance?
They know never reply.
So there was no test.
It's fake.
I just hold that.
Yeah.
I mean, this is how the whole thing fits together, right?
Because the drugs do work.
I mean, I've taken them.
My wife has taken them, and we've experienced their effects firsthand.
I know you've taken them as well.
And you might have experienced a drug effect.
They generally tend to do a few things.
I mean, things like Lexapro, SSRIs,
that generally tend to be cause emotional constriction or blunting or numbing or something along that range.
You know, things like, well, Butrin can be stimulating,
things like Remmeron can make people sort of blunt it and kind of tired. But that can be experienced
as therapeutic. Like if you're a nervous Nelly and there's a lot of stuff going on in your life and you
take a drug to sort of mask that, something that knocks out the highs, something that knocks out the lows,
your experience may be this is better than what I was feeling before. I feel more in control
under this drug effect. And yes, sure, it's not fixing like the under the underlying. The underline
lying problem that you had. But it is making you feel better from the drug effect. However, when you
look at it like that, it also becomes really concerning from like a moral perspective, because
effectively what we're doing is we're giving someone drugs to mask how they feel. And there's
all these sort of ramifications because we're emotional beings, right? You know, we care about
our relationships with others and our friends. You know, we care about the work that we do.
and finding purpose and meaning in our lives.
If there are genuine things happening in our life
that need to be addressed for us to feel happy,
we don't want to numb those things.
We don't want to put a damper on those messages
that are saying, hey, something's not quite right.
And it doesn't have to just be emotional.
I mean, there's problems in our food at the moment
that's making us sick, that's making us inflamed,
and that's also going to make people feel unwell.
The real issue is, I mean, we are, we have a mental health system that doesn't really care about getting to the root causes and helping people.
We just, we just sort of like paper over symptoms.
And so that person in the comments who's just like, it really helped me.
Sure, it's helped you now.
But where I sort of come into this is I see what happens like 10 years down the line, 20 years down the line when people want to come off.
That's like a moment of time.
and masking your sort of like your smoke detector in your brain that's telling you like
something's not right, you know, feel anxious, get curious.
If you mask that for several decades, you can end up in a very bad place later on.
What are the side effects and risks that we're not told about whenever we get a prescription
for an antidepressant?
The main ones that everyone should know and that unfortunately aren't mentioned is,
so some of these are quite uncommon, but they're serious.
when they happen. So the first one would be post-SSRI sexual dysfunction. And essentially this is
a neurological injury that can occur when you're on the medication. And typically what happens is
someone will take the drug, they'll experience sexual dysfunction. It's a very common side
effect for many antidepressants. I think like 70 to 90% of people will experience a decrease in
libido. Men will have things like erectile dysfunction because of it. But
when they start to come off the medication either that doesn't get better or it gets worse there's
actually something about coming off the drug that damages the nervous system even more and so these
people will they'll be on the drug they'll have sexual dysfunction they'll come off it will get worse
and they start to experience genital numbness and so they lose all uh i guess it's i mean it's
called erogenous sensation but it's just you know your private parts they feel differently
than the skin on the rest of your body.
And they'll say it either feels numb like it's had anesthesia
or it feels like the sensation on like the back of your hand.
There's no erogenous sensation down there.
That feels good.
The men will have a lot of erectile dysfunction as well.
They'll be less interested in sex.
But the thing that these folks complain about
even more than the sexual problems
is that they feel emotionally blunted
and they have some mild cognitive impairment.
Sometimes actually it's not mild all the time.
Sometimes it can be bad.
And they feel like it's almost like their sensory system has been like totally turned down from this.
And they'll describe things like they're watching their life through a TV, you know.
And they'll lose things like when their favorite song comes on on the radio that they used to listen to growing up.
And, you know, you'd have this like prickle on the back of your neck with just like nostalgia and joy.
They'll lose that.
You know, when they hug their children or when they hug someone that they love like a family member,
They don't feel those warm emotions anymore.
And they describe just walking around, you know, they have sexual dysfunction and they're super numb.
And for many people, this doesn't go away.
This actually has quite a bad prognosis.
A lot of the other things that we may talk about, the prognosis is kind of better, like the withdrawal injuries.
But for many people with PSSD, yes, some will get better, you know, in a couple years.
But there are people that have been suffering from this for years.
and particularly in the United States, people are not told about that.
And it's in vast contrast to the rest of the world where this is in the drug labels
and doctors are warning them about it.
Wait, PSSD is not in the drug labels for these in the United States?
PSSD is not in the drug labels.
I am shocked to hear that.
I did not know that.
How is that possible?
Why?
I mean, this is going to almost feel like the matrix scene, you know, where it's like,
Do you want the red pill or do you want the blue pill?
We want the red pill.
You want the red pill?
Yeah.
Okay.
So I used to work in the pharmaceutical industry and I used to work at the FDA as in the division of psychiatry as a drug regulator.
So I've kind of seen what happens behind the scenes there.
The whole PSSD thing, I mean, it's been in the literature for like 20 years, but around 2015, 2016, David Healy is a psychiatrist in the UK.
really great drug safety researcher. He got like 100 people plus who had PSSD. He interviewed them. He
collected their stories. He asked permission from their doctors to say, hey, were there any other
explanations other than the drugs? The doctor said there weren't. And he said, hey, can I include
your name in this dossier? And then he sent it out to all of the medical agencies saying, I think
I found a new side effect. It's called PSSD. It's very serious. And so there's these hundreds of
patients and these doctors saying that it's real. So it goes to the EU, EU approves it, it goes to
Australia, Australia approves that Hong Kong does, Canada does. And so we have all these major
drug regulators around the world doing it. And then it comes to the FDA and the FDA puts it on
ice. It went in there in 2018 and no one picked it up at all. It just sort of sat there on the
back burner. Now the reason for this is that psychiatrists in the US, and this includes psychiatrists in
the FDA, they are so captured by the pharmaceutical industry that they act more like advocates
for the drug than actual scientists. They don't want to find problems with them because it's
very uncomfortable and inconvenient for them. And so they've just, they sort of just like let it
sit on the side and they haven't addressed it, which is insane if you think about it. They haven't
even given a response. They got sued recently, but the lawsuit got dismissed.
people from the PSSD network along with another nonprofit was just like, you guys need to
respond to this and you need to do it now.
And so they're looking into it, but they haven't updated the labels yet because I think
it's just going to be embarrassing and it's going to make them look very, very bad.
Well, who cares?
People are freaking suffering.
Does Dr. Marty McCarrie, head of the FDA, have you ever spoken to him?
Do you know he knows about this?
No, but I don't know if he knows about this.
Okay.
I'll start the ball rolling.
I'm going to make sure people tell them.
Could you explain how the biochemical mechanisms behind SSRI's work in the brain?
And are these mechanisms fully understood?
The way SSRI's work is, so they block serotonin re-uptake.
And so it increases the amount of serotonin between the neurons.
And that sounds like very circumscribed and well-defined.
But then there's a whole, like, you know, serotonin isn't functioning like an island
on its own in the brain. I mean, it's affecting all of our other neurotransmitters,
noropenephrine, dopamine, estrogen, hormones. I mean, we're essentially changing the way the brain
functions. We don't actually know fully what these drugs are doing. We don't? We don't. I would think
like these have been around for so long. We've done a lot of scientific research on these drugs.
It's hard to know. I mean, the part that I think is a lot more concerning in terms of like what we
don't know about the drugs is actually what they do long term. Because when we look at the studies
that we have supporting the long term use of them, it's actually very poor because we've got
50% of Americans on antidepressants have been on them for five years. And they've often been told by
their doctors that these drugs are safe and effective. 20% of women, nearly 20% of women are
taking antidepressants these days. So and then people are always shocked when I tell
them, there's been no clinical trials that lasted longer than a year looking at what these drugs
do long term. Now, say that again. There have been no clinical trials with Cibocontrols,
active controls of any sort where you can see what these drugs are doing past a year. And so when
doctors are telling people, hey, these drugs are safe and effective, the part that they're leaving out
is for the year that we studied them. Oh my gosh. And do SSRI's affect different people differently?
Yes. Yeah, absolutely. So, you know, much like we were talking about before with cannabis, you know,
you can have paradoxical reactions. So, you know, some person is going to have the expected therapeutic
effect, which is one of emotional constriction or numbing, you know, but then some people can get more
aggressive on them. And that's why there's, and then some people can become suicidal. And then there's
this whole part of it where they talk about SSRIs and antidepressants potentially being linked
to school shootings. Because we've had so many cases of people becoming unexpectedly suicidal and
aggressive when exposed to it. So, okay, so you brought up when it comes to side effects that people
don't know about with SSRIs. You brought up PSSD. What are some other side effects that people don't realize
when they're taking antidepressants they're at risk for.
I think it's interesting to talk about the most common side effect,
which is actually the drug effect.
There are some other ones.
We definitely should talk about how hard they are to come off later on.
But one of the problems with antidepressants is they're emotionally numbing to people.
And so you're turning off that sensor in your brain that's saying,
hey, there's something not working right in your life,
whether it's a relationship or a job.
And to me, I think that is the biggest risk.
It's being cut off from your intuition and they're not realizing that you need to make changes in your life.
And what are we seeing when it comes to increases of anxiety and depression on an antidepressant?
The antidepressants can sometimes make people more anxious and more depressed in the long run.
And so this is mainly an issue for long-term users.
most chemicals when you take them long term are harmful to the brain, especially ones that act on your neurotransmitters.
I mean, if we think of like drugs of abuse, alcohol can cause something called Wernicke-Korsikov, which is a type of dementia, you know, methamphetamine and cannabis.
When used long enough, they also show neurological changes in the brain.
But then even shifting over to psychiatric meds, you know, we talked about the antipsychotics.
you know they cause permanent movement disorders benzodiazepines cause a condition called bind
which is potentially for some people irreversible neurological problems lithium when you take it long
term causes some irreversible cognitive problems it's called silent syndrome and so the same thing is
happening with antidepressants and the term for that is tardive dysphoria and here's what it looks like
so when i see patients who have been on antidepressants for a long time when they do develop this
how they describe feeling is they start to feel really numb. So they feel emotionally disconnected.
They start to have anxiety that doesn't even seem to be linked to anything anymore. It's just this
constant background anxiety. They have some cognitive problems and then they also have some
cognitive impairment. Frequently what happens is that these folks will get diagnosed with a condition
called treatment resistant depression, which really isn't like it sounds like it's
this more severe form of depression, but essentially just means you haven't responded to two different
antidepressants. It's not recognized that they're actually having a toxic reaction to being on the drug
long term, where the right thing to do for them would be to say, hey, this isn't working for you
anymore. In fact, it's putting you in this sort of blunted, dissociated, anxious state where you have
no motivation and you just don't feel like doing anything anymore. You'd want to bring them off the drug.
And I've done that several times and the people do get better. That's often missed. It's called
treatment-resistant depression. They start putting them on higher and higher doses. They add new
medications. They give them ketamine, TMS, and sometimes even ECT. And essentially what they're
doing is blaming the person. They're not recognizing that the drug has actually made that individual
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How do you feel as a psychiatrist about primary care physicians being some of the main people
prescribing, you know, antidepressants to people? I think it's malpractice. I mean, if we think about
antidepressants, right, you know, here is a pill that will turn off the smoke detector.
in your brain to the problems in your life.
I mean, there's just so much in that.
I mean, you would need to know about their relationships.
You would need to know about their work.
You'd need to know about their health.
You'd need to be spending so much time with that person
to make sure you're not actually making them worse.
People who are on these drugs as well
frequently don't even realize when they're affecting them negatively
because they're affecting their mind
and they have less insight when their brain is sort of in that chemical spell,
if you will.
so you have to go and talk to their spouse as well or people who know them.
Is that what you do?
Yeah, yeah.
If you're doing psychiatry right and you're prescribing mind-altering drugs
which change people's personalities and behaviors where the person can't even realize
if it's helping them or hindering them sometimes, you have to talk to family members as well.
Now, a family medicine doctor, they have like 15 minutes with some people.
maybe it's like six, seven minutes of face time.
Maybe half of that they're talking about like some other issue, like a cardiovascular thing.
And then it's just like, oh, you're depressed.
Have this.
Yeah.
There's no way.
I mean, there's absolutely no way you could use those medications in a safe way when you actually think about what they do and the consequences it could have for a person.
So that's basically my story.
Yeah.
I had a 10-minute wellness checkup with my primary care physician a couple years ago.
I had just casually mentioned, you know, oh my gosh, I'm so stressed out right now at work or whatever, like just I had stuff going on.
And she just was like, oh, well, you know, that's no big deal.
Like it just sounds like you're a little bit anxious.
I'll just prescribe you Lexapro.
And I was like, oh, well, what's that?
She's like, oh, it's just like an anti-anxiety medication.
I'll put you on a low dose.
So that's all that happened.
I was not told anything about potential risks, side effects, whatever.
I didn't know any better.
This is way before I had my awakening on pharma.
So I just said, okay.
I got on that.
I remember accidentally, and it was a very low dose, I think I was only on five milligrams,
but I had like ran out or something and didn't go fill my prescription.
And I think I missed like two days.
And I remember driving like I want to, I want to crash into the median.
It was just very like, like I want to do it and I was like resisting.
Like I just, I don't want to be here anymore.
And I was like, something's not right.
I got to fill my prescription.
Now what's interesting is like now what I know is that it's not to be.
or anxiety coming back. It's like part of the withdrawal, right, of like not being on these drugs
starting to kick in. Yeah. So then I got back on and then anyway, I myself started, which you probably
like, don't do this, but I started kind of tapering off and I just started like cutting like a third
of it off and then eventually like after several months went down to a half and then, you know,
so I tapered myself off and I fully got off Lexapro probably in about six months, which may be too
fast. I don't know. I didn't have any issues getting off, but I was also in a very low dose and
I didn't even notice, besides when I didn't take it that time where I felt like I had ideations
happening, I didn't ever notice like a big difference in that I was feeling better or less
anxious at all while being on the drug, thank God. But that's my story on it. How long were you on
it for, Alex? I think probably like two years. Now, what I want to ask you is in your follow-up
appointments with your family doctor, how much did they talk to you about how long are you going to be
on the med for.
Never.
What was the discussion?
Was it just like kind of,
they just kept refilling it?
Or was this?
Just like,
and you're still on the Lexpro?
Yep.
Okay.
That's it.
Yeah.
There's no discussion.
It wasn't like,
hey, has your job gotten better
or anything like that?
No.
Have things changed in your life?
Are you sure you want to be on this?
Never.
I don't think that's that uncommon
for many people.
I talk to people and they're like,
hey, I was anxious because I moved away
for college.
and they just get put on an antidepressant, and then like 15 years later,
they're just like, oh, you just kept refilling it.
And it's like, you feel like made your brain dependent on this drug,
like cemented this thing together for like 15 years now.
Yeah.
And they're just like, just like let it go.
So what is the correct tapering process for getting off SSRIs or antidepressants?
So, yeah, so this is really my specialty and what I do.
And so it's symptom-led tapering.
and so I'm going to provide some parameters here.
There's variability in how people respond to coming off these meds.
Some people, their brains are super elastic and they could survive a rapid taper.
You know, they can come off after, you know, two months.
You know, some family medicine doctors will do it that quickly.
And they'll feel poor, but, you know, maybe a month later, you know, six weeks later, they're okay.
There are a lot of people out there where that's way too fast and they become really
symptomatic and they become suicidal, they've become anxious like they've never imagined,
they have cognitive problems as well, and to get them off the medications, you have to do it
much, much slower. So generally, I think if someone has been on antidepressants for over a year,
they should do one of these slower tapers. I typically recommend people knock the dose down by
five to 10% per month, and then they just adjust it as they go. You know, if you do that,
and you're feeling fine, just knock another 10% off.
But as you get lower, you generally need to slow down.
And this is actually the part of it where most people fail their tapers,
or they'll end up just on like a small dose at the very bottom.
And I'll try not to get too scientific here,
but I do think it's helpful to imagine this.
At the higher doses of antidepressants, you know,
there's a space between two neurons,
and it's just flooded with the drug.
And so let's say it's like 60 of Prozac, which would be one of the higher doses.
Jeez.
You could drop that down by half and really not change receptor occupancy at the neurons
because there's still so much drug like floating around.
So you're on half the dose and it's still like pretty much the same.
But once you get down to the lower dose range of a drug, as you remove more and more,
there's less of the excess just like floating around in that space and then you start to
disengage the receptors much more and so many people will feel like oh you know I knocked you know
10 off the prozac and I went to 50 and it was fine and I knocked another 10 off and I got to 40 and it
was fine and then they get all the way down to like let's say 20 and then knock another 10% off
and then they feel it and they go oh no you know what's happening I'm never going to be able to get
off this drug. And what are they feeling? So what they're feeling is that they've reached this tipping point
where there's no longer this big saturation of leftover drug, you know, sitting between the neurons.
And now there's not that much left. So they're really feeling each reduction. So, and this is the
part where people fail. When you get to the lower doses of the drug, you have to understand that you have
to move much slower. So eventually when someone will hit this withdrawal is usually,
when I tell them to go and get a liquid formulation of the drug because it's really hard to just
break the tablets in half at that point. You don't really have the level of precision that you need.
And so let's say you had 10 of Prozac, you would just get 10 milligrams and put it into 10 milliliters
of the drug. And then because the syringe has so many like fine gradations on the side,
you can actually lower it down with much greater precision than if you were to be.
be, you know, breaking up a tablet. And so from that point onwards, you might just have someone
remove one milligram, you know, every two to three weeks. And then they can go down like that.
The key point here is, do not panic if you go into withdrawal at the end. You probably need to go
onto a liquid formulation and then use a syringe to sort of steadily bring it down. And that's
the way you can safely get someone off. And what's the typical timeline for how long it takes
someone to fully get off an SSRI.
Like, are we talking about a year, two years?
What is it?
I would say it's one to two years if someone's been on them for like, you know, more than a
couple of years.
If somebody's experiencing brain zaps as they're trying to taper off, like, what's
your recommendation for how to deal with that?
Go up.
Okay, so you need to go back up on the...
Yeah, go back up.
And this sort of links into one of the problems with antidepressant withdrawal, which
most people aren't aware of.
And it's a condition called protracted withdrawal.
Now, this doesn't happen to everyone, but it's going to sound really scary.
This actually, most people are okay when they go through abrupt withdrawals,
but there is a fraction of people out there that if they come off the medications
and they go into one of these bad withdrawal syndromes like you mentioned with like brain zabs
or they have like really high anxiety, that can almost be experienced like a concussion
or like a neurological injury.
And so for some people, when they have a lot of these withdrawal symptoms, it doesn't get better, even when they reinstate the drug.
And this can be a completely devastating condition that can go on for years.
And that's what I try and do with these slow tapers, because it's not harmless to just stop the drug in two months.
It can actually, you know, it can cause really devastating problems.
And if you give me a bit of leeway, I'll kind of tell you a story about sort of how this happens.
You have someone, they go and see a family medicine doctor.
They say, oh, you can come off in two months.
And then they go into withdrawal and they start to have brain zaps and high anxiety.
And they're sitting there and they go, I'm just going to white knuckle through it.
I'm just going to tough it out.
I don't want to lose my gains because I know it's just going to get better.
And they're having really, really bad anxiety and brain saps.
Now what happens is, and for reasons I don't understand, somewhere around like the, you know, the one month mark, two month mark, three month marks, sometimes it's even further out than that, the bottom falls out. And they stop just having brain zaps. They start to develop like severe anxiety, cognitive impairment, ringing in their ears, light sensitivity, gastrointestinal problems, like they develop IBS, you know, tingling in their hands and feet. And then they panic and they go, oh my God, what is happening to me? This is. This is.
is terrible. And so they think, I must be in withdrawal. The withdrawal is getting worse. And then
they try and take the drug to make it go away, but it doesn't go away. And that's because they're not
in withdrawal anymore. Because they've been sitting in that acute withdrawal, it's sort of built
up to a point that's actually damaged their brain. And that condition, that one does get better for
the vast majority of people, but sometimes it can take, you know, 18 months, two years, sometimes even
longer for it to fully resolve because it's not a withdrawal it's it's almost like you've had a
concussions like you've had a neurological insult holy smokes um and there's hundreds of thousands of
these people online who have been neglected they they hang out on places like if you ever want to see
a dark corner of the internet you can go to surviving antidepressants.com it's like hundreds of
thousands of these people who have had these antidepressant injuries and they've just been
completely forgotten by people.
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And then, of course, there's the wonderful world of over-the-counter allergy meds
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Lexa Pro was recently approved for kids as young as seven.
What are your thoughts on prescribing SSRIs to children?
To me, it does not make sense unless someone has tried absolutely everything else
because there's a boxed warning on antidepressants for suicidal behavior.
And this is especially a problem.
in people under age 25 that the younger you are, the more likely you are to experience it.
It's due to these paradoxical reactions and the younger you are, the less mature your nervous system is
and the more likely you are to have a bad response to it.
And when they looked at the clinical trials, Alex, there were more suicide attempts on the people
who got the drug than the people who were just given placebo.
When we're talking about giving these drugs to children, you're essentially giving a kid a drug
where they're more likely to have a suicide attempt than if you were to do nothing.
And so for me, I really struggle to think about why we give these medications to people
under age 25 at all because, yes, you know, it lowers the symptoms on the depression rating
scale. But the outcome you really care about is really suicidal behavior with something like
depression. And when you look at it in that way, you're more likely to have a suicide attempt
on the drug than if you were just given placebo. So for me, it's like, don't do it.
How do you predict children who start taking SSRIs at such a young age will fare in adulthood,
particularly if they remain on the medication for decades?
I think it's, for me, it's scary. Like, I'm a drug safety guy. And so I'll talk about some
animal studies, which I've seen. And so when we look at what happens to mice who are exposed to
antidepressants in utero, you know, like in the mom's belly, or to baby mice who are exposed
growing up and maturing, their behavior is different from the other mice. I mean, it has an
effect on how the nervous system develops. They engage in less mating behavior. And they're stopped.
You know, they're just exposed during that time. And then they're not given antidepressants anymore.
And so there's an effect on the nervous system that just changes how they function socially.
It's also concerns that in humans, that antidepressant exposure, when the, you know, in utero,
you know, when the mother is pregnant, leads to an increased risk of autism as well.
And so there's these behavioral things that I worry about, like just simply from interfering
with the maturation of the central nervous system.
But then there's the, so, what I see to be like a clear, like, emotional issue.
And that is that you're going to suppress someone's emotional development.
Because part of growing up is, you know, getting rejected by a crush, feeling like excluded sometimes, getting upset, you know, feeling uncertainty about your life and your job and all of these things.
and when you turn the volume off on that, you can have people who are emotionally stunted.
I've taken people off, you know, cocktails of meds, which they've been on for 20 years,
and they tell me that when they come off, it's like all of their emotions are back,
and they're learning how to deal with them for the first time when they're like 40,
when everyone else has sort of worked through all of these messy emotions,
which are a normal part of development.
and you sort of rob someone of that.
You rob them of the opportunity to really work through their emotions.
And you can get into relationships that you wouldn't have gotten into while you're on the medications.
You can settle for jobs that you wouldn't have settled for while you're on these things.
And so, I mean, there's just so many ways, essentially drugging your brain can have all of these different effects as you're growing up and trying to figure out who you are.
And so I'm guessing there's no long-term research on the effects of SSRIs on children, like, being on it forever.
No, no, there's this not.
And I mean, we didn't even talk about the fact that, you know, you're like this massive sexual dysfunction from these drugs.
And so you're also going to rob a teen of going through, you know, normal being excited about being, you know, sexually active.
And if you just blunt all of that as well, it's kind of like.
a very special experience for a young, for a teen and a young person to go through. And if you take
that away, I mean, that's lost. I mean, in a way. And I mean, this is a whole other debate. And I don't
know your thoughts on it. But like, you know, there's this debate about, you know, the trans movement and
allowing minors to transition and putting them on hormones and, you know, basically castrating
them medically and what that will do to them. In a way, if you were putting a child on an antidepressant
for years and years and years, I mean, couldn't we, that.
that also be another form of medical castration? Yes, it can be. And I mean, the thing, you know,
I'll say the quiet part out loud, because this is something that I worry about. And long ago,
I sort of got over not just speaking my mind on things. I actually, I do worry that the increased use
of antidepressants in young people and I've shown pregnant mothers may contribute to people
having gender dysphoria. You know, like we saw in the animal studies, this less mating
behavior in the kids who grow up exposed to antidepressants. I've spoken to several people with
PSSD who tell me when they developed it. They were used to being attracted to, you know, I spoke
to two men and they normally they have normal sexual attraction towards like a woman. And when
that went away because they developed PSSD, they started to think that they were gay, essentially.
I do think it can lead to gender dysphoria, confusion about your sexual identity. If you,
your brain sort of matures going through this, if you blunt someone's normal sexual functioning.
And this is the scariest thing here. There's actually some data about this. A researcher,
Yazi Priiani and Travis, they did a study. It was published, it was commented on in the New York
Times a few years ago. They went out and they did a survey of people identifying as LGBTQ.
And I think 30% of them were taking antidepressants. And when they asked, they are,
them, you know, what percentage of you had enduring sexual dysfunction when you came off
the antidepressant? It was 13% of them. To me, it's like, well, what came, like, could that
be a reason why you're identifying as LGBTQ if you got on an antidepressant and then you
experienced enduring sexual dysfunction and now you have gender dysphoria and identity
confusion? Because they're attributing, like, oh, I can't like keep an erection because maybe I'm not
attracted to the sex. Yeah. It's really just a side effect of the drug. Yeah. Yeah. And how you're not
feeling, you're looking around and everyone else is having kind of normal sort of sexual
connections with each other and you don't feel that. Wow. I think you're onto something there.
Yeah. If that happens to you and then you're in sort of one of these places where people like just,
you know, they say they do these evaluations to make sure you're really, you know, you really need
the surgery. But it's just a bunch of like psychologists like cheerleading people like to the finish line.
I mean, you can pretty much ruin their life and their family's life forever.
Like if that was not what was going on.
And that's kind of like evil when I think about it.
I mean, it's probably one of the sickest things that you could do is to miss that.
100%.
Now, do you have similar concerns about kids on ADHD medication?
ADHD medications generally they tend to be safer in terms of like horrific.
Like I think PSSD is horrific.
I think protracted withdrawal is horrific.
People coming off ADHD meds
aren't having those problems.
They're not having neurological injuries.
The thing that I worry about the most
with ADHD meds is really like addiction.
You know, ADHD is sort of like an,
it's as a disease,
it's like an interesting concept, right?
Because when you go to societies where, you know,
it's you sit down and you work
and you need to be like disciplined
and it's like really like you're almost,
you're worth as a person is like,
how much you contribute and how successful you are, you're going to see a lot of ADHD there
because anyone that doesn't fit that mold who isn't able to sort of achieve in that way,
they're going to be like, oh, I feel like something's wrong with me.
And so that's why in places like the US, which are really like that, we're going to have
sky high ADHD rates.
When you go to places like France or other places, they're like, no, there's more variability
in how people are.
You know, not everyone is meant to be sitting down and studying at a desk.
What I really worry about in the US is because we have this culture.
that so that valorizes like success and you know doing all of these things that people they put
themselves on on these medications and one they can get into jobs that they really shouldn't be doing
because then they to actually do the job they need to be on the stimulants but they also get sort of
like lulled into this this state of mind that really does lead to addiction and that is when my mind
isn't working the way that I want it to work I can just take something to fix it like
you feel like a young person, oh, my diet's crap and, you know, I can't concentrate because of that.
I'll just take some adderol. I went out drinking last night with my friends and now I have to get up
and go to college and, you know, I have to focus. I'll just take some adderol. It's so ubiquitous now
that I think people feel like that's really normal. And so what I see with ADHD meds is people get on
that, they'll start that, they'll have a crash in the evening. They'll start to drink more beers
to kind of deal with that.
And then again, just hacking their neurology,
or they'll start taking benzodiazepines.
And when they start to eventually get more anxious
because they're on Xanax and it does that long term,
then eventually they start getting on an antidepressant.
And it just starts this like this spiral
where it just started with an ADHD medication
and now someone's like using all of these different medications
to sort of like hack their neurochemistry
rather than just being like,
hey, you were okay the way you were.
And maybe there needed to be,
you needed to find a different,
thing that you could do to be okay.
Now, I've heard somebody describe ADHD medication before as legal meth, essentially.
Do you think that that's a fair description or do you think that's kind of disingenuous?
No, I think this is completely fair distinction.
I mean, there's a drug called Dysoxin that is methamphetamine.
Like, it's actually methamphetamine, the active ingredient.
It is an ADHD medication that you can take.
It's a third-line therapy for it, you know, after you try riddlin and adderol.
but methamphetamine, like the methamphetamine people smoke, you can get that in a tablet
from like, you know, your big box pharmacies for ADHD.
And can kids take this?
Yeah, if they have treatment resistant ADHD.
Oh my gosh.
Like we draw this like distinction that like, no, those are the street drugs and these
are our safe medications, but no, they're just, they're all stimulants.
Wow.
How quickly can post-SRI sexual dysfunction develop once you start taking it?
Is it like, oh, you got to be on it for like six months or more for develop?
It could be like you took it one time.
It could be after only, you know, decades on the pill.
We've seen it all.
So I think, I mean, I've spoken to several people where it's developed within one to two pills of it.
And then some people where it's happened over a much longer period of time.
I think it's very unlikely, very, very unlikely that it happens after a couple pills.
But yeah, that can happen.
I was recently interviewed by Glenn Beck.
And he's kind of like learning because of the Mahaha movement.
He's kind of learning for the first time about all this like big pharma, big food stuff.
So he doesn't know that much.
And people that are fans of Glenn, they know his story is that his whole family, like his mother and all and everybody in his immediate family struggle with severe depression.
And Glenn was basically suicidal and then got on antidepressants.
And he says like, that saved my life.
So his question for me was about like, how do you explain an entire family all having severe depression?
Two, how do you explain if it is a placebo, how like immediately I took it and I felt like, okay, like I'm better?
I don't really buy it.
I don't think antidepressants are a placebo at all.
I think they have a very obvious drug effect, like if you're paying attention.
I mean, when I was, when I took Zolov, like it was just like, it was like a pain of glass separated me from the world.
I felt serene and like I was disconnected. And my wife would be, you know, complaining about the state
of the home. And I'd just be like, I don't care. You know, it's just like, oh, everybody's going to
want their husbands to be on that then. No, she's like, I hate you on Zoloft. And I was like,
oh, I'm just experimenting with. I'm just trying it. So, and so, yeah, there's this idea that if you take
it, you know, you're going to have this expectation. It'll make you better. And then you'll just feel
well. And that's what they do. It's just placebo. It's just this psychological trick from a sugar pill.
no way you know there's a there's there's there is an obvious drug effect from being on them that that
is kind of numbing and disconnecting so it's not placebo Glenn how do we describe um why his family
is is depressed and and you know this is where nuance is needed um so there can be you know what
what makes people depressed i mean for me as a psychiatrist i think about you know like medical
problems are there medical problems that you know is there mold in the house you know is it is there
dietary issues going on, you know, is there substance, substance use, misuse. But if you
rule out all of those things, I mean, the other thing is, is there trauma in the family, you know,
are there stressful things happening around them? So you kind of go through all of these,
these causes for depressed mood. If you can't find any of them, there's no problem with
sort of falling back on maybe this is depression that is arising from more of a biological cause.
because there are some people who generally tend to be more neurotic,
you know, they're warriors and they slip into depression more.
And so I do think there are some people that are kind of tilted that way, and that's just...
But it's not a chemical imbalance.
Well, it's not like a well-defined chemical imbalance where it's like you could point to it in a brain
and just say, this is the actual problem.
We're really just talking about, you know, variations in how people are.
And truthfully, Alex, I mean, maybe one day they're, they're,
there will be something that they find. I think they'll probably find something for schizophrenia.
I'm not that convinced that they're going to find something for like anxiety and depression.
I think it's way too complicated. And it's probably like polygenic, meaning that there's multiple
different genes involved. It's not going to be this like neat little solution that we can like
fire a drug at. And so there's no issue with someone like Glenn or someone like taking a medication
if they've done everything else, you know, done the therapy. You look, you look, you look,
looked at your diet, your lifestyle, you're not smoking lots of pot.
If you're still feeling really bad, you can take an antidepressant.
I mean, if someone's informed you about the risks and you're just like, I really need this to
function, there should be no shame in that.
And so there are going to be some people out there, you know, maybe like Glenn, who's done
everything and he's taken it and it's been helpful for him, he should be able to, he can do that.
And I have no problem with that.
And I think that's reasonable.
The issue is that we rob people of that, the way we practice it these days, because we do these
transactional visits.
No one tries to motivate anyone or help them do these other things.
Yeah.
And so, yeah, they're robbed of the opportunity of trying something that's less harmful,
and they're not told about the risks.
What do you think causes schizophrenia?
I don't think it can be explained away by trauma or stresses in someone's life.
There's a lot of things that look like schizophrenia.
I mean, the main thing I think is cannabis-induced psychosis.
Like that looks like a psychotic disorder.
But for someone who hasn't had that, I don't know what it's caused by.
Researchers don't.
But I do think they'll probably find something eventually because, you know, the way it presents
is you have someone who's, you know, in their late teens, early 20s, and they just tank.
You know, their cognition goes down.
So they start to experience delusions and paranoia.
And they never quite recover.
And then they sort of live at this lower level of functioning sort of,
drifting in and out of psychosis throughout their life, I don't think there's a trauma that's
severe enough. I don't think there's life stresses that could be so bad that it would kind
of tilt someone into that level of dysfunction. And so the cause of it, I lean more on like
a genetic biological side for that one, which we haven't quite found. Do you see any connection
between the overprescription of antidepressants and the rise in mental health issues like depression
and anxiety in recent generations.
I think these drugs are making a lot of people worse.
I mean, for multiple reasons, I think for some people, they're harmful to the brain long-term.
I mean, we talked about tired-dive dysphoria.
And I also think that we've sold people on a lie, you know, that the solution to their
problems is, you know, in their brain to be fixed with a chemical.
And I think any time you don't actually fix something at the root cause, it just festers and
it gets worse.
So if not SSRIs, what are the most effective treatments for depression?
So I think it's the things that are really intuitive to a lot of us.
I mean, we're emotional beings.
I mean, so our relationships are really important, you know, finding meaning and what we do, you know, having work that we enjoy, having freedom as well.
I think those things are all essential from an emotional standpoint.
You know, financial insecurity, although that's harder to treat for some people.
I mean, you can't really treat.
It's not really in the domain of a doctor to treat poverty and things like this.
More of a societal thing.
So there's that.
And then we have like your physical health.
I mean, the food that you put into your body, I mean, our brains are connected to our body by our neck.
You know, if we don't look after our body, we're going to feel unwell.
We're designed to move as well.
Like if you're someone who's just like anxious and just like, what's going on?
It's like, are you moving your body?
Are you exercising?
we're not we're also not designed to be you know smashing cups of coffee and like you know
using nicotine products all day and like hacking our you know hacking our biology i mean so you got to
cut all of those all of those things out um i mean that's where i would start uh with helping people
with depression i mean and these things aren't quick fixes you know finding the love of your life
or a friendship group that you like that's like can take decades you know finding work that you find
meaningful and that is fulfilling that this is like life cultivation. This is this is things that
people will spend decades working on us. So it's not a quick fix. So do those things first. And
we don't want to say no to antidepressants completely. It's just like you want to do the things that
are much safer before you go and lean on a drug that can, you know, in rare cases, because things like
PSSD that can be really hard to come off. And and so use the antidepressants. And so use the antidepressants.
But don't just like jump on it because a family doctor tells you to do in like a seven-minute
visit.
Is there evidence to support that certain lifestyle changes or nutritional interventions are as
effective as taking an antidepressant?
There's heaps of evidence for that.
You know, when they look at long-term outcomes for antidepressants versus psychotherapy, you know,
for the studies that go over a year, you know, psychotherapy does better than the antidepressant.
When they look at exercise, that does really well when they do observational studies and they look at dietary interventions, people that do anti-inflammatory or Mediterranean diets do better.
And there's all of these studies out there, even in severe mental illness that are coming out of places like Stanford recently showing ketogenic diets can actually reverse bipolar disorder and schizophrenia for some people.
Well, and Dr. Chris Palmer is who's doing a lot of the work on that.
and he's phenomenal. I'm hoping to get him on the show soon to talk about all of that and the gut-brain connection and everything.
But yeah, it's fascinating the stuff that they're finding out. Do you think that the public is becoming more aware of the risks associated with long-term use of SSRIs or is the conversation still very one-sided?
So I think we're breaking through. I mean, there's me and there's a lot of people like me who are just, you know, we're talking about this all the time on social media, trying to just get the word out through earned media.
But yeah, I mean, we're competing against essentially an industry that has unlimited funds and has infiltrated academia by, you know, take, you know, essentially all of the academics in there get funding from the drug companies and they're not going to say anything negative about them.
And so we're constantly battling this group of people with a war chest of resources that, you know, the message is essentially, you know, these drugs are super safe and they're really effective.
But, I mean, we're breaking through.
Tell us about the Taper Clinic.
What is it?
So the Taper Clinic is a business.
My wife and I started back in about five years ago.
And as I mentioned, I was in the FDA and in the pharmaceutical industry.
And when I left, I was just so disgusted by how we were not practicing in alignment with what the evidence showed.
So we decided to make a clinic to help people safely come off these meds.
That's all we do.
You know, we take people off psychiatric meds.
We help them find non-drug approaches to deal with their mental health problems.
We're in the 10 most populous states in the U.S. and a couple more.
You know, it's all available on our website.
And we hire a lot of people who have been drug injured.
I'd say about more than half of the people that work in the clinic as clinicians
have been on psychiatric meds.
They've come off.
So they can relate to the patients?
They can relate to them, yeah.
You know, a clinic run by people have been personally affected by, you know, over-drug.
and withdrawal injuries, and that's what we do. It's sort of structured like a rehab. So it's,
you know, people that come, they work with us long term. We do slow, safe tapers.
What advice would you give somebody who is just beginning their antidepressant treatment journey
and, you know, they feel a little stuck in the cycle of prescription medication?
I mean, you need to trust your intuition would be the first thing. I mean, really think about it.
are there things in my life that need to be getting addressed?
You never want to end up just on the medication, and that's like the treatment.
You know, if you're going to use it, it needs to be done in conjunction with fixing my relationship, my job, my health, and my exercising,
getting off cannabis and, like, other drugs.
Am I using too much like coffee and nicotine?
You want to do it with all of these other things that are really well known to help improve your health.
And there should always be an exit plan.
I mean, you should be thinking about this medication, like, how am I going to get off this?
You know, what's the fastest way to get to a place where I don't need this anymore?
I think if you're thinking about it in that way, you'll be safe.
And then obviously get educated on how to come off it safely eventually because you don't want to get hurt on the way off.
Are people able to work specifically with you if they want to?
I'm the medical director.
So right now I'm overseeing all of the cases in the clinic.
Okay.
And how can people get in touch?
Best way to get in touch just to come to our website, which is, you know,
is you know, www. Taper, T-A-P-E-R clinic.com.
If you could offer one remedy to heal a sick culture,
and that could be physically, emotionally, or spiritually, what would it be?
Purpose.
I think that's, I think that is the driving force for many people.
It's finding something that you believe in and that you can go after and you can build
your life around it.
I think when people have purpose, a lot of things fall into place for them.
Thank you for coming on Culture Apothecary, Dr. Joseph.
Thanks for having me, Alex.
If you enjoyed this episode, make sure you go back and listen to my interview with Dr. Roger McPhillan on the same subject from a few years ago.
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