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What if the hardest part of coming off an antidepressant isn’t the first cut, but the last milligrams? We sit down with Dr. Mark Horowitz—clinician, researcher, and someone who’s been through withdrawal himself—to unravel why standard advice fails, how the brain adapts to medication, and what a safer exit really looks like.

Mark shares his first taper attempt after 13 years on Lexapro, a methodical plan that still crashed into panic, derealization, and hours of daily terror. That lived shock led him to survivingantidepressants.org, hyperbolic tapering, and ultimately co-authoring the Maudsley Deprescribing Guidelines and national guidance in the UK. We dig into the science behind tolerance and homeostasis, the neuroimaging that explains why tiny doses can have big effects, and the practical tools—liquid formulations and small percentage reductions—that let people step down without falling off a cliff.

We also take on the evidence base. Most psychiatric drug trials are short, yet millions stay on meds for years. Stopping studies often confuse withdrawal with relapse, inflating claims for maintenance. Mark clarifies the difference between dependence and addiction, why precise language matters for care, and how stigma warps clinical decisions. Therapists play a pivotal role here: they see clients more often than prescribers, can spot emotional blunting, sleep disruption, or nausea early, and can educate on withdrawal patterns so patients don’t mislabel their experience.

This conversation is grounded in compassion and straight talk. We explore the scale of harm—protracted withdrawal, sexual dysfunction, and misdiagnosis—and why many clinicians never see it: patients quietly disappear when “simple” tapers go wrong. There are hopeful signs too. UK systems are shifting toward hyperbolic tapering and better-informed consent, while US momentum builds as more professionals engage with deprescribing science and patient stories. If you’ve wondered whether your plan is safe, if a rough patch means relapse, or how to work with your clinician on a slower schedule, you’ll leave with a clearer map and concrete next steps.

If this resonates, subscribe, share with someone planning a dose change, and leave a review to help more people find evidence-based guidance on safer tapering.

We're recruiting for a first-of-its-kind psychiatric medication withdrawal research study. If you've experienced psychiatric medication withdrawal, you may be eligible to participate.  Email DrTeralyn@DrTeralyn.com to learn more. 

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💊 Ready to Deprescribe Your Psych Meds?

Psych meds have harmed us—and we’re not just survivors, we’re deeply educated in psychopharmacology, psychology, and nutrition. As hosts of The Gaslit Truth Podcast, we guide people safely off psychiatric medications with strategies grounded in science and brain health

🔥 You’ve been harmed. You’ve been dismissed. It’s time to take your brain back—with guidance from people who’ve been there and know their stuff.

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