This episode is essential for millions of women who’ve been on antidepressants for years or even decades. Dr. Mark Horowitz, a British-Australian psychiatry researcher, neuroscientist, and lead author of clinical deprescribing guidelines, offers an honest conversation about the science, marketing myths, and long-term effects of antidepressants, including emotional numbing, weight gain, disrupted sleep, and cognitive changes. Dr. Horowitz explains the difference between addiction and physical dependence, why withdrawal symptoms are often mistaken for relapse, and the evidence-based method of hyperbolic tapering.
Whether you’ve been on an antidepressant for two years or twenty, you’ll leave with smart questions for your prescriber, a clear sense of your own readiness, and reassurance that tapering off slowly and carefully has a success rate of over 90%.
Episode Overview:
0:00 Intro/Teaser
5:53 Midlife misdiagnosis
10:25 How life events became medicalized — and why that matters
17:29 Long-term side effects
26:11 The serotonin hypothesis
30:51 Addiction vs. physical dependency
38:50 Withdrawal vs. relapse: How to tell the difference
48:14 Hyperbolic tapering explained
56:40 How to know if you’re ready to come off your antidepressant
1:09:24 What to say to your doctor
1:16:34 The After-Party with Dr. Stephanie
Resources mentioned:
- Powerpoint slides on Withdrawal research, Mark shows during the episode
- Outro Health (US): www.outro.com
- Mark’s book on how to safely stop antidepressants and other psychiatric drugs
- Deprescribing clinic in the NHS (for UK patients)
- Umbrella review of the serotonin theory of depression (2022), published in Molecular Psychiatry
- Tapering of SSRI treatment to mitigate withdrawal symptoms (2019), The Lancet Psychiatry
- Single-Dose Effects of Citalopram on Neural Responses to Affective Stimuli in Borderline Personality Disorder: A Randomized Clinical Trial
- Depression, antidepressants and fall risk: therapeutic dilemmas—a clinical review
- The Research Landscape: Why Short-Term Studies Miss the Full Picture
- BBC Panorama documentary
- Zoloft “blob” advertisement
Bio:
Mark Horowitz, PhD, is an Australian and British psychiatry researcher and deprescribing expert. He is the lead author of Deprescribing Guidelines and works as a Clinical Research Fellow in psychiatry at North East London NHS Foundation Trust, running a deprescribing clinic. He holds a PhD in the neurobiology of depression and the pharmacology of antidepressants from King’s College London. More at www.markhorowitz.org and x.com/markhoro
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I’m Dr. Stephanie
Part geek, part magic, and all the way passionate about being a well-lived woman.
I want to throw my grandkids in the air in my 70’s. I want to be squatting even more weight than I am now, and putting my OWN luggage in the overhead bin. Sound like weird goals? For me these are just some of the little things that represent a life well-lived.
My health is MY job – I’ll be damned if I rely on luck, ‘good genes’ or a cocktail of drugs that over promise and under deliver.
The Betty Body is my first book-baby, and a collection of what I’ve learned after thousands of clinical hours, hundreds of conversations with the world’s top experts, and most importantly…
This book is an outline of what took ME from “rock-bottom health” at 38, to being my own version of a Betty in my perimenopausal mid 40’s. A woman who is physically strong, full of energy, enjoys mental clarity, great sex and a joyful family life. Is it all roses? Of course not. But I have the stamina and tools to deal with the push and pull of life so that it doesn’t turn into chronic stress.
I want this for you too. Let’s go Bettys!
