RFK Jr. launches plan to address 'overuse' of psychiatric medications

2,247 Views | 32 Replies | Last: 5 days ago by V8Aggie
Ryan the Temp
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https://www.cnn.com/2026/05/05/health/rfk-jr-overprescribing-psychiatric-drugs-wellness
Quote:

US Health and Human Services Secretary Robert F. Kennedy Jr. announced a plan to reduce "overprescribing" of psychiatric medications and support alternative treatment options and discontinuation of medications when needed.

"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," Kennedy said Monday at a MAHA Institute summit on mental health and overmedicalization. "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."

I think this is a really good move, and a great deal of attention should be focused on overprescribing medications to children and young people. Anecdotally speaking, what I've seen in a university environment is that a very large percentage of college students are on some form of medication these days. I've even seen kids sitting around comparing what meds they are on and encouraging their friends to go ask their doctor to prescribe specific drugs. It was mind-blowing to witness.

Sometimes I think these kids are medicated for no reason other than bad parenting or a refusal to take responsibility for their own lives and decisions.
TacoKitKat
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Long overdue. The efficacy of psychiatric medications is questionable for the majority of people that are taking them. Absent severe depression or disorders like bipolar disorder or schizophrenia, they're largely placebos with occasional negative side effect profiles and moderate cost. They're probably prescribed more out of liability aversion than any medical need for most patients. Kids are simply a more likely demographic to get diagnosed and treated due to the influence of parents and administrators combined with the natural ups and downs of growing up.
dustin999
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Quote:

Sometimes I think these kids are medicated for no reason other than bad parenting or a refusal to take responsibility for their own lives and decisions.


We also live in a crazy complex world with a ton of environmental factors (weird **** being taught in schools, victimhood mentality among groups of people, social media, devices, crazy indoctrination and propaganda). Not saying the meds are justified, but even with exceptional parenting, there's still a ton of landmines in society to navigate, and parents unfortunately can't be everywhere all the time.
Logos Stick
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I've taken an SSRI before and it helped me. Hope this doesn't end up like opioids where millions are forced to suffer in pain because doctors refuse to prescribe them because of government overreach.
HillcountryAg97
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Just to say children and young adults, for sure, but geriatric depression and delusions, especially within the population of significant dementia, is likely undertreated as a comfort measure and counted against physicians and facilities when it can be capable of providing comfort to patients and families alike.

I'd be in favor of supporting things like counseling and psychiatric services(increase fee for service type attraction to the field) to mitigate these things but favor as little government broad based regulations as possible.


Just a thought to add to the convo.

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YouBet
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Logos Stick said:

I've taken an SSRI before and it helped me. Hope this doesn't end up like opioids where millions are forced to suffer in pain because doctors refuse to prescribe them because of government overreach.

Valid. Hopefully, RFK can thread the needle here, but we are certainly over prescribing meds to kids. At ridiculous levels.

Had a recent surgery and my doctor was *****ing about what he has to do to get opioids to his patients who need them.
HillcountryAg97
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Absolutely. Would sure hate to see overreach create any type of hesitation or stigma.
No material on this site is intended to be a substitute for professional medical advice, diagnosis or treatment. See full Medical Disclaimer.
pfo
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I like RFK Jr but I don't think government involvement concerning prescribing medicines should override the doctor patient relationship. The doctor that's personally spent time with and evaluated the patient knows better than the government that has not spent time with and evaluated the patient.
TacoKitKat
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Logos Stick said:

I've taken an SSRI before and it helped me. Hope this doesn't end up like opioids where millions are forced to suffer in pain because doctors refuse to prescribe them because of government overreach.

Nobody's disputing your experience of having gotten better after starting an SSRI, the question is what caused it.

The research doesn't say SSRIs do nothing, it says the drug-placebo difference is clinically insignificant for most patients. Kirsch et al. (2008) pulled every trial submitted to the FDA for four major antidepressants and found that the apparent benefit at higher severity levels was driven by decreased placebo responsiveness, not increased drug effectiveness, meaning a lot of people who got better on SSRIs would have gotten better on a sugar pill they believed in. You very likely didn't get better because of the drug. You probably got better because you believed you would. That likely sounds invalidating coming from a stranger over the internet, but this is the case for the majority of people who purport benefit from these drugs.

The opioid comparison is orthogonal to your point. Opioids work, full stop. The efficacy was never in question, the scandal was distribution and addiction. With SSRIs the efficacy itself is the fraud, and we've been in the overprescription era for thirty years without knowing it because the negative trials were buried. Turner et al. (2008) pulled FDA records for 12 antidepressants and found published effect sizes inflated by 11-69% per drug, 32% across the class. The literature looked good because pharma made sure the literature looked good.

I can't debate your feelings. But the data is pretty clear on this one, starting with Kirsch's work in 2008 and continuing up through 2022 when the serotonin deficiency hypothesis itself, the entire mechanistic rationale for why SSRIs were supposed to work, was quietly gutted by a 2022 umbrella review in Molecular Psychiatry.

We've been prescribing a solution to a problem that probably doesn't exist the way we thought it did, and everyone who took a pill and who would have gotten better anyway now believes in them.
Ryan the Temp
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pfo said:

I like RFK Jr but I don't think government involvement concerning prescribing medicines should override the doctor patient relationship. The doctor that's personally spent time with and evaluated the patient knows better than the government that has not spent time with and evaluated the patient.

I completely understand and appreciate where you're coming from here, but it does seem clear that the prevalence of these types of drugs is associated with some real problems. I was talking with my doctor at my physical last year and he complained about direct marketing of drugs. He said he has multiple patients every week come in and ask to be prescribed some drug they saw on TV.
Sid Farkas
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Logos Stick said:

I've taken an SSRI before and it helped me. Hope this doesn't end up like opioids where millions are forced to suffer in pain because doctors refuse to prescribe them because of government overreach.

idk what your experience was when you quit taking them, but I tapered for three months and it was awful. However I'd never discourage anyone from taking any med prescribed by their doc...
Howdy, it is me!
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TacoKitKat said:

Logos Stick said:

I've taken an SSRI before and it helped me. Hope this doesn't end up like opioids where millions are forced to suffer in pain because doctors refuse to prescribe them because of government overreach.

Nobody's disputing your experience of having gotten better after starting an SSRI, the question is what caused it.

The research doesn't say SSRIs do nothing, it says the drug-placebo difference is clinically insignificant for most patients. Kirsch et al. (2008) pulled every trial submitted to the FDA for four major antidepressants and found that the apparent benefit at higher severity levels was driven by decreased placebo responsiveness, not increased drug effectiveness, meaning a lot of people who got better on SSRIs would have gotten better on a sugar pill they believed in. You very likely didn't get better because of the drug. You probably got better because you believed you would. That likely sounds invalidating coming from a stranger over the internet, but this is the case for the majority of people who purport benefit from these drugs.

The opioid comparison is orthogonal to your point. Opioids work, full stop. The efficacy was never in question, the scandal was distribution and addiction. With SSRIs the efficacy itself is the fraud, and we've been in the overprescription era for thirty years without knowing it because the negative trials were buried. Turner et al. (2008) pulled FDA records for 12 antidepressants and found published effect sizes inflated by 11-69% per drug, 32% across the class. The literature looked good because pharma made sure the literature looked good.

I can't debate your feelings. But the data is pretty clear on this one, starting with Kirsch's work in 2008 and continuing up through 2022 when the serotonin deficiency hypothesis itself, the entire mechanistic rationale for why SSRIs were supposed to work, was quietly gutted by a 2022 umbrella review in Molecular Psychiatry.

We've been prescribing a solution to a problem that probably doesn't exist the way we thought it did, and everyone who took a pill and who would have gotten better anyway now believes in them.


Very interesting! Thanks for sharing.
ATM9000
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Ryan the Temp said:

pfo said:

I like RFK Jr but I don't think government involvement concerning prescribing medicines should override the doctor patient relationship. The doctor that's personally spent time with and evaluated the patient knows better than the government that has not spent time with and evaluated the patient.

I completely understand and appreciate where you're coming from here, but it does seem clear that the prevalence of these types of drugs is associated with some real problems. I was talking with my doctor at my physical last year and he complained about direct marketing of drugs. He said he has multiple patients every week come in and ask to be prescribed some drug they saw on TV.


Sure. But why isn't the move then to just ban direct to consumer marketing prescription meds like practically the rest of the world has?
Martin Cash
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ATM9000 said:


Sure. But why isn't the move then to just ban direct to consumer marketing prescription meds like practically the rest of the world has?

Prescription med advertising used to be illegal, just like ambulance chasers.

The good ol' days.
ts5641
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More greatness from RFKJ. Next work on over prescribing statins.
ts5641
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pfo said:

I like RFK Jr but I don't think government involvement concerning prescribing medicines should override the doctor patient relationship. The doctor that's personally spent time with and evaluated the patient knows better than the government that has not spent time with and evaluated the patient.

There was a time when you could trust doctors. I don't anymore. They're all in the pocket of big pharma. They believe the solution to every problem is a pill. That pill usually comes with multiple bad side effects worse than the original issue in which the meds were prescribed.
Of course the doc will get his kickback and island vacay sponsored by pharma.
ETFan
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More policy from ignorance, nice.
ETFan
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ts5641 said:

pfo said:

I like RFK Jr but I don't think government involvement concerning prescribing medicines should override the doctor patient relationship. The doctor that's personally spent time with and evaluated the patient knows better than the government that has not spent time with and evaluated the patient.

There was a time when you could trust doctors. I don't anymore. They're all in the pocket of big pharma. They believe the solution to every problem is a pill. That pill usually comes with multiple bad side effects worse than the original issue in which the meds were prescribed.
Of course the doc will get his kickback and island vacay sponsored by pharma.


Will this trope ever die?

Speaking of dying, you all agree to do that at home and not at the untrustworthy hospital, right?
Rex Racer
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pfo said:

I like RFK Jr but I don't think government involvement concerning prescribing medicines should override the doctor patient relationship. The doctor that's personally spent time with and evaluated the patient knows better than the government that has not spent time with and evaluated the patient.

I think RFK would agree with you. He's just talking about taking ownership of your own health, and for the doctors to stop and think and talk to their patients, rather than just saying, "Here's a pill."
nomad2007
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ts5641 said:

More greatness from RFKJ. Next work on over prescribing statins.


Statins? You mean amongst lower risk groups? Because they're underused in high risk groups and probably by a big margin.
Emotional Support Cobra
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Martin Cash said:

ATM9000 said:


Sure. But why isn't the move then to just ban direct to consumer marketing prescription meds like practically the rest of the world has?

Prescription med advertising used to be illegal, just like ambulance chasers.

The good ol' days.


I bet the TV lobby is keeping this going since 90% of the ads are drugs or insurance. Where would they get their ad dollars otherwise.
Squadron7
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I wonder how many pills could be replaced by simple exercise that patients just won't do.
Logos Stick
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TacoKitKat said:

Logos Stick said:

I've taken an SSRI before and it helped me. Hope this doesn't end up like opioids where millions are forced to suffer in pain because doctors refuse to prescribe them because of government overreach.

Nobody's disputing your experience of having gotten better after starting an SSRI, the question is what caused it.

The research doesn't say SSRIs do nothing, it says the drug-placebo difference is clinically insignificant for most patients. Kirsch et al. (2008) pulled every trial submitted to the FDA for four major antidepressants and found that the apparent benefit at higher severity levels was driven by decreased placebo responsiveness, not increased drug effectiveness, meaning a lot of people who got better on SSRIs would have gotten better on a sugar pill they believed in. You very likely didn't get better because of the drug. You probably got better because you believed you would. That likely sounds invalidating coming from a stranger over the internet, but this is the case for the majority of people who purport benefit from these drugs.

The opioid comparison is orthogonal to your point. Opioids work, full stop. The efficacy was never in question, the scandal was distribution and addiction. With SSRIs the efficacy itself is the fraud, and we've been in the overprescription era for thirty years without knowing it because the negative trials were buried. Turner et al. (2008) pulled FDA records for 12 antidepressants and found published effect sizes inflated by 11-69% per drug, 32% across the class. The literature looked good because pharma made sure the literature looked good.

I can't debate your feelings. But the data is pretty clear on this one, starting with Kirsch's work in 2008 and continuing up through 2022 when the serotonin deficiency hypothesis itself, the entire mechanistic rationale for why SSRIs were supposed to work, was quietly gutted by a 2022 umbrella review in Molecular Psychiatry.

We've been prescribing a solution to a problem that probably doesn't exist the way we thought it did, and everyone who took a pill and who would have gotten better anyway now believes in them.



"statistically small average effect" <> "doesn't work."

Even if the average effect looks small, that doesn't mean it's meaningless. With major depressive disorder, outcomes aren't evenly distributed - some people get little from SSRIs, and some get a lot. When you average that together, it can make the benefit look trivial even though it's clearly not for everyone.

Kirsch is not the final word. There's been a lot of back-and-forth since then, and later analyses still find that SSRIs beat placebo, especially in more severe cases. Not by a huge margin, but consistently enough that guidelines continue to recommend them.

The placebo effect is ubiquitous to all medicine. The question is, does the drug have benefits on top of that.

So unless you're arguing SSRIs have zero real effect, my opioid comparison still applies: it's a tradeoff where some people take on risks so others can see real benefit.
WBBQ74
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Now get the drug ads off the tv and radio. I miss the funny Miller Lite ads.
Emotional Support Cobra
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Squadron7 said:

I wonder how many pills could be replaced by simple exercise that patients just won't do.


HoW dare YoU!!1
Hoyt Ag
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Squadron7 said:

I wonder how many pills could be replaced by simple exercise that patients just won't do.

I would bet half.
YouBet
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Rex Racer said:

pfo said:

I like RFK Jr but I don't think government involvement concerning prescribing medicines should override the doctor patient relationship. The doctor that's personally spent time with and evaluated the patient knows better than the government that has not spent time with and evaluated the patient.

I think RFK would agree with you. He's just talking about taking ownership of your own health, and for the doctors to stop and think and talk to their patients, rather than just saying, "Here's a pill."


For anyone who has had an older family member with health issues, you learn quickly that you have to own your own health. No one is going to do it for you.

Ex: The sheer amount of conflicting drugs that are prescribed once you get more than one doctor involved is maddening. They rarely talk to one another and will overrule each other based on their opinion putting you in a spot that you don't know which medication should be taken and which should be stopped.
Ryan the Temp
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ATM9000 said:

Ryan the Temp said:

pfo said:

I like RFK Jr but I don't think government involvement concerning prescribing medicines should override the doctor patient relationship. The doctor that's personally spent time with and evaluated the patient knows better than the government that has not spent time with and evaluated the patient.

I completely understand and appreciate where you're coming from here, but it does seem clear that the prevalence of these types of drugs is associated with some real problems. I was talking with my doctor at my physical last year and he complained about direct marketing of drugs. He said he has multiple patients every week come in and ask to be prescribed some drug they saw on TV.


Sure. But why isn't the move then to just ban direct to consumer marketing prescription meds like practically the rest of the world has?

Call me jaded, but Big Pharma has deep pockets and politicians are easily bought.
Teslag
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YouBet said:

Rex Racer said:

pfo said:

I like RFK Jr but I don't think government involvement concerning prescribing medicines should override the doctor patient relationship. The doctor that's personally spent time with and evaluated the patient knows better than the government that has not spent time with and evaluated the patient.

I think RFK would agree with you. He's just talking about taking ownership of your own health, and for the doctors to stop and think and talk to their patients, rather than just saying, "Here's a pill."


For anyone who has had an older family member with health issues, you learn quickly that you have to own your own health. No one is going to do it for you.

Ex: The sheer amount of conflicting drugs that are prescribed once you get more than one doctor involved is maddening. They rarely talk to one another and will overrule each other based on their opinion putting you in a spot that you don't know which medication should be taken and which should be stopped.


This is why it helps to have a long time doctor in a good modern network. My physician has a patient portal and I upload and keep it synced with my VA providers. Both have knowledge of meds from each because I do the legwork.

Own your health.
Rex Racer
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YouBet said:

Rex Racer said:

pfo said:

I like RFK Jr but I don't think government involvement concerning prescribing medicines should override the doctor patient relationship. The doctor that's personally spent time with and evaluated the patient knows better than the government that has not spent time with and evaluated the patient.

I think RFK would agree with you. He's just talking about taking ownership of your own health, and for the doctors to stop and think and talk to their patients, rather than just saying, "Here's a pill."


For anyone who has had an older family member with health issues, you learn quickly that you have to own your own health. No one is going to do it for you.

Ex: The sheer amount of conflicting drugs that are prescribed once you get more than one doctor involved is maddening. They rarely talk to one another and will overrule each other based on their opinion putting you in a spot that you don't know which medication should be taken and which should be stopped.

Yes, I encountered this with my father. I had to take ownership of his health because he was no longer capable.
Martin Cash
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Emotional Support Cobra said:

Martin Cash said:

ATM9000 said:


Sure. But why isn't the move then to just ban direct to consumer marketing prescription meds like practically the rest of the world has?

Prescription med advertising used to be illegal, just like ambulance chasers.

The good ol' days.


I bet the TV lobby is keeping this going since 90% of the ads are drugs or insurance. Where would they get their ad dollars otherwise.

Exactly. Pharma, trial lawyers, medicare supplement plans and car warranty plans. Without them, 90% of TV ads disappear.
BadMoonRisin
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I think the truth is somewhere in the middle.

Are they effective for certain people? Yes
Are the overprescribed? Also yes.
V8Aggie
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Placebo effect is certainly real. I remember in law school health ethics class reading about a placebo cancer treatment that caused the cancer to regress. Though it did return fairly quickly. Quite fascinating.

I certainly believe SSRIs have a place and definitely help people but we need to be careful with our youth and over prescribing. They need to be taught coping skills and healthy habits. These meds shouldn't be used long term.

Obviously not a doctor. I've used various SSRIs in the past to get through some very difficult life circumstances paired with quality therapy. While they helped, the drowsiness side effects and numbing were something I couldn't tolerate long term. With therapy I was able to come off with no issues.
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