As a nurse in the antidepressant 2.0 era, I'm teaching my patients to cut down their doses using jewelry scales

Kristen Massingill, a 36-year-old nurse practitioner, explains how she helps patients gradually reduce their antidepressant doses. She works at Outro, a de-prescribing startup that recently secured $7 million in funding. Massingill, who has over 15 years of healthcare experience, began her career in the ER before transitioning to hospice, palliative care, and electrophysiology.

Currently, her main focus is on assisting patients in discontinuing antidepressants. She notes that withdrawing from these medications can cause severe withdrawal symptoms, such as insomnia, brain fog, dizziness, appetite changes, and mood shifts. Many people discontinue their medications because the symptoms are too debilitating or are mistaken for a relapse.

Massingill initially saw the need for de-prescribing when she encountered patients struggling to come off their antidepressants. She emphasizes that her role is to support patients through the withdrawal process, rather than convincing them that their symptoms are not related to antidepressants. Some patients take a hands-on approach, weighing their doses using jewelry scales or having compounded tablets specially prepared with incremental dosages.

The process of tapering antidepressants varies for each patient, depending on their individual circumstances and preferences. Massingill tailors the tapering timeline to fit each patient's needs, sometimes holding a dose for an extended period or adjusting the approach based on life events. She encourages patients and learns from their experiences, contributing to the evolving culture around antidepressants.

The US Department of Health is expected to release new de-prescribing guidelines this year, reflecting increasing recognition of this practice in psychiatry.