Trump, RFK Jr. go after SSRIs in executive order. Here's how they work
Immediately following Robert F. Kennedy Jr.’s confirmation as health secretary, President Donald Trump instructed his administration to assess the “threat” posed to children by the prescription of selective serotonin reuptake inhibitors (SSRIs), antipsychotics, mood stabilizers, stimulants and weight-loss drugs.
This came as part of an executive order installing Kennedy’s “Make America Healthy Again” commission, which aims to end the “childhood chronic disease crisis” and the “over-reliance on medication and treatments.” Kennedy’s vow to crack down on artificial additives and ultra-processed foods resonated with many voters, but he has been a controversial figure, too, repeating conspiracy theories that falsely linked vaccines to autism and antidepressants to school shootings.
Trump’s executive order caused panic among individuals reliant on SSRIs and other psychiatric medications to manage their mental health. So what exactly are SSRIs and what has RFK Jr. said about the medications in the past? Here's what you need to know.
‘If they take these medications away, it will cause mass tragedies’
Trump's executive order quickly became a trending topic, and while it focused on children and adolescents, the online conversation broadened to include all SSRI usage. One post defending SSRIs garnered upwards of 5 million views.
"Literally would not be alive today without my SSRI. But that’s probably the point,” one user posted on X.
“SSRI's literally saved my life. I had debilitating depression and anxiety with suicidal ideation, and it has transformed me to be able to handle my mental illness and keep harmful thoughts away,” wrote another X user. “If they take these medications away, it will cause mass tragedies.”
Others tried to assure those concerned that the executive order won't have immediate effects: "I'm on a lot of meds that are specifically mentioned in the order. My point is they're still in the exploratory phase. Nobody is taking away our meds any time soon," said one Redditor in response to a thread about the news, which was nearing 200 replies.
Another tried to calm the heated reactions on Twitter, "RFK Jr has always advocated for medical freedom and informed consent. You can have your SSRI’s, but you also deserve to know the side effects. Anyone saying he will ban anti-depressants are paid shills. Carry on."
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How do SSRIs, antidepressants work?
Suicide is a major public health crisis – according to the CDC, 49,000 people died by suicide in 2022, which is about one death every 11 minutes. Additionally, 12.3 million adults seriously thought about suicide, and 1.6 million made a suicide attempt. Antidepressants can be life-saving for people struggling with depression, OCD, anxiety and other mental health conditions when alternative treatments like talk therapy aren’t working, but they should always be monitored closely by a doctor, especially in pediatric patients.
Selective serotonin reuptake inhibitors (SSRIs) are a class of antidepressants that treat depression and other mental health conditions by increasing levels of serotonin — a neurotransmitter that helps regulate mood, appetite, sleep, memory, social behavior and libido — in the brain, according to Cleveland Clinic.
According to the National Institute of Mental Health, 8.3% of U.S. adults ages 18 or older had a major depressive episode in 2021; for those aged 18-25, this rate jumped to 18.6%. The lifetime risk of suicide among patients with untreated depressive disorder is nearly 20%, compared to a high-end estimate of 4.6% in the general population.
With depression rates on the rise, the monthly antidepressant dispensing rate for young people also increased by 66.3% from January 2016 to December 2022, according to a 2024 study in the journal Pediatrics.
Antidepressant-induced suicidality is an uncommon occurrence, but a “legitimate phenomenon.” Young people under the age of 25 are more likely to experience suicidal ideation when they first take SSRIs compared to other SSRI users, according to NHS. Close monitoring and follow-up care is vital following the introduction of a new antidepressant (like with most medications), and some patients may need to switch antidepressants or use a different class of psychiatric medications to find the right fit.
For example, for individuals with bipolar disorder, SSRIs are associated with an increased risk of a manic episode, so preferred medications are mood stabilizers, antipsychotics, norepinephrine-dopamine reuptake inhibitors (NDRIs, such as Wellbutrin, that work by increasing the levels of norepinephrine and dopamine in the brain), and/or serotonin-norepinephrine reuptake inhibitors (SNRIs).
Symptoms of bipolar disorder can appear differently in children and adolescents, such as having faster mood cycles, and can go often misdiagnosed. Pediatric patients experiencing mental health symptoms should remain in close communication with their physicians, especially if they are being treated with psychiatric medications.
Differences in how SSRIs work in adolescents compared to adults are still poorly understood. More research could further inform best treatment practices.
RFK Jr. has likened antidepressant withdrawal to heroin, falsely linked SSRIs to school shootings
During his confirmation hearing with the Senate Finance Committee on Jan. 29, Senator Tina Smith (D-MN) accused RFK Jr. of spreading lies and misinformation, particularly when it comes to mental health care and antidepressants.
In 2024, Kennedy speculated that antidepressant use could explain the rise of school shootings, despite a lack of scientific evidence to support such claims.
When Smith asked Kennedy if he stood by this scientifically-unfounded claim, he lacked a clear response. “It should be studied along with other potential culprits,” he said.
But studies show no causation between antidepressant use and school shootings, and Smith added that “most school shooters were not even treated with antidepressants,” and among those who were, there was “no evidence of association.”
"SSRIs, and psych meds in general, are not responsible for mass shootings or violence in any way," Dr. Ragy Girgis, an associate professor of clinical psychiatry at the Columbia University Department of Psychiatry and the lead researcher of a 2022 study on mass murders, previously said in an email to Paste BN. "These psych meds have specific anti-violence properties.”
People with untreated serious mental illness are more likely to be victims of violence or self-inflict harm than be violent towards others.
Kennedy proceeded to compare SSRIs, a common type of antidepressant including Prozac, Zoloft and Lexapro, to a heroin addiction.
“Listen, I know people, including members of my family, who’ve had a much worse time getting off of SSRIs than people have getting off heroin,” he told Smith. Kennedy was previously addicted to heroin.
In July, Kennedy also referred to a broad group of people who take ADHD medication or SSRIs and people who are dependent on opioids and benzodiazepines as “addicts.” He unveiled a plan to send people struggling with addiction to “wellness farms” in rural areas. During his Jan. 29 hearing, he clarified that these treatment programs should be available, but not forcibly attended.
But psychiatric nurse practitioner Sean Leonard, who focuses on addiction medicine, disagrees with any comparison between SSRIs and heroin.
“Serotonin receptor sites versus the opiate receptor sites is night and day,” Leonard says. “It’s so hard to come off an opiate. Your brain craves it, your body craves it; serotonin, not so much.”
What is 'antidepressant withdrawal'?
Taking someone off of an SSRI is called the “withdrawal process,” Leonard says, but it’s “nothing to the extent like opiates.” People typically taper off their doses, and may experience headaches, tiredness and anxiety, he adds.
People are more likely to have antidepressant discontinuation symptoms if they suddenly stop taking their medication (as opposed to tapering their doses), have been on the medication for years or take a high dose, according to the Cleveland Clinic.
Withdrawal symptoms usually start within 5 days of stopping the medicine and last 1 to 2 weeks, and are typically mild, according to the NHS and American Academy of Family Physicians. However, some people have severe withdrawal symptoms that last for several months or more. One study showed that these symptoms can last up to one year, but according to the Cleveland Clinic, another study showed that 2% of people who experienced discontinuation symptoms had lasting symptoms for three or more years. There has been a push from some experts for doctors to adequately warn patients of withdrawal symptoms before starting an SSRI, and for more reproducible studies to be executed on antidepressant withdrawal, which can inform future guidelines.
However, some symptoms can be a relapse of the depression the antidepressants were treating and not ongoing withdrawal symptoms. People should create individualized treatment plans with their prescribing physician when considering getting on or off psychiatric medications.
Non-medication treatment methods for depression can include psychotherapy (such as cognitive behavioral therapy), art therapy, social support and lifestyle changes like improved sleep hygiene, exercise and diet.
Contributing: Hannah Hundall
This story has been updated to include more information.