Short Wave Podcast Summary

Episode: Stopping SSRIs Can Be Hard. Researchers Are Unsure Why
Date: September 2, 2025
Host: Emily Kwong (NPR)
Guests: Emily Corwin (investigative journalist, APM Reports), Dr. Michael Hengartner (Professor of Clinical Psychology, Kaleidos University of Applied Sciences, Switzerland)

Main Theme / Purpose

This episode examines the difficulties some people have when trying to discontinue SSRIs (selective serotonin reuptake inhibitors), the most commonly prescribed antidepressants in the U.S. Host Emily Kwong, alongside investigative journalist Emily Corwin and clinical psychologist Michael Hengartner, explore why science has yet to fully understand long-term SSRI withdrawal effects, what patients are experiencing, and what research is lacking in this area.

Key Discussion Points and Insights

1. Prevalence and Personal Story

• SSRIs are the most common antidepressants: Over 1 in 10 people in the U.S. take them (00:17).
• Emily Corwin’s Experience: Emily Corwin, who was on Lexapro (an SSRI) for 15 years, shared her struggle discontinuing the drug (00:41).
  • She started SSRIs for mild depression and remained on them, as “nobody ever suggested I do anything else.” (Emily Corwin, 01:04)
  • When tapering off Lexapro, Corwin suffered unexpected and intense symptoms:

    “I just, for the first time in my life, experienced a kind of excruciating existential dread that didn’t make any sense to me. I’d never had anything like that before. I felt kind of out of body experience.”
    (Emily Corwin, 01:22)

  • Returning to her original dose relieved these symptoms instantly.

2. Patient Movement and Research Gaps

• Corwin investigated further and “an entire Internet of information about withdrawal opened up” (02:07).
• Thousands form online communities and nonprofits, sharing experiences of prolonged withdrawal—lasting months or years (02:15).
• Lack of clear definition and consensus around SSRI withdrawal:

  “The whole problem starts with a lack of definition. And so actually we’re left quite in the void.”
  (Dr. Michael Hengartner, 02:38)

3. Medical Guidance and Risks of Stopping SSRIs

• Do not abruptly stop SSRIs:

  “Abruptly stopping a drug is probably the worst thing you could do.”
  (Dr. Michael Hengartner, 05:01)

• There’s no universal rule for tapering; the process must be individually tailored. Some can taper off quickly, others need more time. More research is needed to predict who needs what (05:09).

4. Withdrawal Symptoms—Beyond The Known List

• Symptoms range widely and include:
  • Somatic/Neurologic: Dizziness, “brain zaps” (described as electrical shocks in the head), gait instability (05:56).
  • Physical: Flu-like symptoms—sleep problems, appetite changes, diarrhea (06:22).
  • Psychological: Mood changes, irritability, panic, anxiety (06:54).
• “Brain zaps” is a patient-coined term, not a formal medical diagnosis.

5. Contested Research and Study Limitations

• A recent JAMA Psychiatry paper (last month) analyzed existing research and concluded no significant long-term withdrawal symptoms (07:14).
  • Critique: The paper was based on mostly short-term (8-12 week) studies, not reflective of real-world, multi-year SSRI use:

    “You cannot expect that when you look at eight week studies or when people stop a drug after eight weeks, that this is informative or tells me something about what happens if someone stops the drug after five years.”
    (Dr. Michael Hengartner, 07:14)

• Most research is patient surveys or anecdotes; there's a gap in robust, long-term studies (08:20).

6. What Research Is Needed?

• Dr. Hengartner calls for honest, long-term studies:
  • Enrolls patients on SSRIs for varying durations (six months, 12, 24 months, etc.)
  • Randomly assigns abrupt vs. slow tapering vs. placebo, then follows for months to distinguish withdrawal from relapse (08:48).
  • “But such a study has never been done.” (Dr. Michael Hengartner, 09:38)
  • Why?

    “Most drug trials…are sponsored by the pharmaceutical industry…No one is interested in studying something that they actually could find something that they do not want to see…So the best way to avoid this problem is you don’t study it.”
    (Dr. Michael Hengartner, 09:42)

  • Regulatory agencies don’t require withdrawal studies.

7. SSRI Withdrawal vs. Relapse

• How can we tell withdrawal apart from depression/anxiety relapse?
  • Hengartner’s research: If “relapse” is mostly due to withdrawal, symptoms appear rapidly after stopping the drug, then lessen; if it's a genuine relapse, risk would increase over time.
  • Data suggest most “relapses” after discontinuation happen quickly—not slowly over time—challenging assumptions that SSRIs prevent recurrence (11:00).

    “…the large bulk of relapses or event coded as relapses occur quite quickly after discontinuation and thereafter, there's mostly salient [not much occurs after].”
    (Dr. Michael Hengartner, 12:11)

Memorable Quotes & Moments

• On lack of research and patient advocacy:

  “…it’s a real credit to the patients who have been organizing and lobbying on their own behalf that the APA is paying attention. I very much hope that the APA…recognizes that the literature has overwhelmingly looked at short term use…and that most of the people…have used these drugs for many, many years…”
  (Emily Corwin, 12:47)

• Dr. Hengartner:

  “To find out who needs what, we…need more research. And we’re not there yet. Not at all.”
  (05:09)

Important Timestamps

• 00:17: SSRIs prevalence and introduction
• 00:41 - 01:59: Emily Corwin describes her personal withdrawal experience
• 02:07 - 02:38: Discovery of online withdrawal communities and lack of clear definition
• 05:01: Warnings against abruptly stopping SSRIs
• 05:56 - 06:54: Detailed withdrawal symptoms
• 07:14 - 08:20: Critique of existing research
• 08:48 - 09:37: What honest research would look like; why it's not done
• 10:32 - 12:11: Discussion of withdrawal vs. relapse and Hengartner's findings
• 12:47: Patient advocacy and APA’s emerging interest

Conclusion

The episode stresses that scientific understanding of long-term SSRI withdrawal is limited, often due to a lack of long-term, independent studies. Patient stories reveal real suffering and are pushing major psychiatric organizations to pay attention. For now, experts recommend individualized tapering plans and more research to uncover who is most at risk for withdrawal, how best to help them, and how to distinguish withdrawal from relapse.
Listeners are cautioned never to stop SSRIs suddenly and to consult healthcare providers for any medication changes.