RFK Jr takes on big pharma with campaign to 'de-prescribe' Medicare patients from SSRIs

Department of Health and Human Services Secretary Robert F. Kennedy Jr. has announced an effort from his department to tackle the overprescribing of psychiatric medications such as SSRIs.

Kennedy said in a statement, "Today, we take clear and decisive action to confront our nation’s mental health crisis by addressing the overuse of psychiatric medications—especially among children. We will support patient autonomy, require informed consent and shared decision-making, and shift the standard of care toward prevention, transparency, and a more holistic approach to mental health."

In a "Dear Colleague" letter, HHS and subagencies such as the Centers for Medicare and Medicaid Services encouraged providers to ensure "that treatment planning for mental health conditions includes meaningful access to evidence-based non-pharmacological interventions," and that "when appropriate," treatment should include deprescribing.

The letter said that while psychiatric medications can play an important role in treating conditions, "At the same time, medication should not be understood as the only treatment option, nor should it be initiated, continued, or discontinued without a careful and individualized discussion of the risks, benefits, and available alternatives."

"Accordingly, HHS encourages clinicians and provider organizations to support a treatment approach grounded in shared decision-making, patient autonomy, and fully informed consent," the letter stated. Patients should receive "clear, understandable information regarding the potential benefits and risks of psychiatric medications at initiation, during ongoing treatment, and when discontinuation is being considered. That discussion should include the purpose of the medication, expected benefits, possible adverse effects, monitoring needs, potential discontinuation symptoms, the risks of abrupt cessation when relevant, the possibility of relapse or recurrence, and the availability of evidence-based non-pharmacological interventions."

"HHS also encourages regular and deliberate review of psychiatric medication regimens to ensure that each medication remains necessary, beneficial, and aligned with the individual’s current clinical needs and treatment goals," the letter continued. "In some circumstances, continued pharmacotherapy remains clearly indicated. In others, clinicians and patients may determine that a medication is no longer providing meaningful benefit, is contributing to adverse effects, has become part of an unnecessarily complex regimen, or should be reduced or discontinued following a thoughtful risk-benefit review."

Speaking at a Make America Healthy Again Institute event on Monday, Kennedy said, "We’re not telling you to stop," but rather the campaign aims to make sure patients and providers "have the information and support to make the right decisions for you."

“That includes a safe, evidence-based path to tapering and discontinuation when clinically appropriate,” Kennedy said, per NOTUS.

The Substance Abuse and Mental Health Services Administration is set to issue a report in May that will outline prescribing trends "to inform efforts to reduce inappropriate prescribing, while maintaining access, along with a fact sheet for prescribers and patients." The agency will also host webinars over the summer for health professionals to "increase awareness of the side effects of psychiatric medications, and approaches for deprescribing, as well as evidence-based nonmedication treatment."

The HHS is also set to convene a Technical Expert Panel in July "to gather input from health professionals, patients and families, government agencies, and professional societies to inform the development of formal HHS clinical guidance on the appropriate use of psychiatric medications and tapering and discontinuation."