We Became a Medicated Society
More than one in ten American adults now take prescription medication for depression. Women receive these prescriptions at double the rate of men. Add in antipsychotics, stimulants, mood stabilizers, and anti-anxiety drugs and you get to roughly 77 million Americans on psychotropic medications. Six million of those are children.
Psychotropic medication has become a defining feature of American medicine.
Many of these long-term users now want to discontinue or at least understand what they are actually taking and why. Most of them started these medications because doctors told them a serotonin imbalance caused their depression. Science does not support that claim.
The Chemical Imbalance Story Fell Apart
Doctors told patients that depression comes from low serotonin and that antidepressants correct the imbalance. Patients believed they had a biological defect that required medication yet the research never supported it.
Psychiatrist Joanna Moncrieff’s umbrella review exposed the lack of evidence for the serotonin theory of depression. Researchers found no meaningful differences in serotonin levels between depressed and healthy people. Tryptophan depletion did not trigger depression in healthy volunteers and the largest genetic analyses found no link between serotonin transporter variants and depression.
Long-term users started digging into the literature themselves, discovering the chemical imbalance theory was marketed as neuroscience and is driving a lot of the tapering demand we see now.
Withdrawal Deserves Serious Attention
The medical establishment spent years treating antidepressant withdrawal as rare, mild but the data says otherwise.
Pooled data from 23 studies shows that more than half of patients attempting to stop antidepressants experience withdrawal symptoms and nearly half rate those symptoms as severe persisting for weeks or months. Patients report failed attempt after failed attempt to discontinue.
Clinicians want to help these patients taper safely and find almost no guidance. National depression guidelines mention tapering but leave out the practical details: dose reduction schedules, percentages, ways to distinguish withdrawal from relapse. A systematic review of these guidelines confirms what practitioners already know. We are on our own.
Patients Built Their Own Deprescribing Culture
Formal medicine offered nothing. People figured it out themselves.
Long-term users started documenting how symptoms changed with each dose reduction, tracking which percentage cuts were tolerable and how long they needed to stabilize between reductions. Their documentation became the first real tapering protocols.
Gradual reduction strategies emerged from patient trials and errors with withdrawal leading to stepwise approaches that accounted for the particular difficulty of lower-dose reductions.
Mad in America expanded public understanding through sustained reporting on tapering and protracted withdrawal and World Tapering Day started in 2022. The patient-led deprescribing community became the primary source of practical tapering knowledge. Mainstream medicine failed these patients.
A Market Emerged Because Standard Care Failed
Unmet need creates markets.
Quietly, brave clinicians built practices around tapering support, often working with compounding pharmacies to supply dose increments that do not exist in standard formulations or IV nutrients to help with withdrawal and deficiencies. Patients willingly pay out of pocket for these services as tapering support has lagged far behind prescribing practices. Some of these practitioners are now training others to do this work. www.ndnr.com/webinar
Washington Finally Noticed
Long-term psychiatric medication use and withdrawal difficulties got too big to ignore. Robert F. Kennedy Jr. became Secretary of Health and Human Services in February 2025, and tapering entered the federal policy conversation.
An executive order created the Make America Healthy Again Commission on Kennedy’s first day, with HHS at the helm. The commission will examine prescribing patterns for SSRIs, antipsychotics, mood stabilizers, stimulants, and weight-loss drugs. The focus on children is explicit. The framing treats these medications as potential contributors to chronic health problems.
The commission’s first report on children’s health identified overmedicalization as a major driver of chronic disease: overdiagnosis, overprescribing, and withdrawal syndromes from stimulants, antidepressants, and antipsychotics. Long-term psychotropic use, withdrawal, and tapering needs are now officially on the federal radar.
Demand Keeps Growing
Long-term users want structured, gradual reductions. Abrupt discontinuation triggers the worst symptoms and patient-led deprescribing communities have spread the word that slow, controlled tapers are possible. Tapering has become an established clinical need.
A Word of Caution
Patients should taper carefully. Abrupt or rapid reductions after long-term use can produce serious physiological and psychological reactions. Even gradual reductions require stabilization periods and flexibility at lower doses, and most of all it requires individualized care.
The research supports slow, stepwise reductions with room to pause or reverse if symptoms intensify. Tapering works best under the guidance of a clinician who understands withdrawal patterns and can tell the difference between withdrawal and relapse.
Dose reduction addresses only part of the clinical picture. Long-term psychiatric medication use disrupts multiple physiological systems that dose adjustment alone cannot restore. These medications deplete the nutrients required for neurotransmitter synthesis. They kill beneficial gut bacteria and feed harmful strains that produce inflammatory compounds crossing into the brain. HPA axis disruption impairs cortisol regulation and stress response. Thyroid axis suppression slows metabolism. Gonadal axis disruption alters sex hormone production. Glucose dysregulation drives weight gain that resists diet and exercise. Mitochondrial impairment causes exhaustion that sleep cannot resolve. Circadian disruption prevents restorative rest. Receptor downregulation demands higher doses for the same effect. Chronic inflammation amplifies withdrawal symptoms. Autonomic instability triggers palpitations, sweating, and temperature swings. Movement disorders produce involuntary muscle contractions. Overburdened detoxification pathways leave drug metabolites circulating longer. The patient who wants to taper arrives already compromised across these systems. Conventional psychiatry assesses none of it.
Naturopathic and integrative medicine practitioners have been treating these systems for decades. Clinical protocols exist for restoring gut microbiome balance, supporting HPA axis function, repleting the nutrients psychiatric medications deplete, and using amino acid therapy to support neurotransmitter production during withdrawal. IV nutrient support addresses deficiencies faster than oral supplementation. Adaptogenic herbs help regulate cortisol. Mitochondrial support restores cellular energy. The research base keeps growing through publications like NDNR and peer-reviewed integrative journals. What conventional psychiatry ignores, naturopathic medicine treats.
Most patients cannot find a clinician with tapering expertise. They turn to patient-led communities or specialized services instead. Patient communities and specialized services keep growing because the need is massive and routine care has not caught up.
Naturopathic medicine offers a clinical framework for addressing these systems. NDNR is hosting Dr. David Arneson’s final 12-week live virtual masterclass: Psychiatric Medication Tapering—A Naturopathic Approach for Primary Care and Support Clinicians. NANCEAC-approved for 21 CE hours (12 Pharmacy, 9 General). Free introductory webinar at www.ndnr.com/webinar
Razi Ann Berry is Publisher of NDNR’s Journal of Applied Natural Medicine, recipient of the AANP Champion of Naturopathic Medicine award, recipient of Mindshare Summit’s Rising Tide and Best Digital Media Awards. She is a 5th generation Arizonan and above all, a mother.
References
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World Tapering Day. About World Tapering Day. Available from: https://worldtaperingday.org
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Trump DJ. Executive Order 14212: Establishing the President’s Make America Healthy Again Commission. The White House; 2025.
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