RFK Jr. Claims Antidepressants Are Harder to Quit Than Heroin – Is It True?

In February 2025, during his confirmation hearing as the U.S. Secretary of Health and Human Services, Robert F. Kennedy Jr. made a provocative assertion: he claimed that discontinuing antidepressants, specifically selective serotonin reuptake inhibitors (SSRIs), can be more challenging than quitting heroin. This statement has ignited a debate among medical professionals, patients, and the public. To evaluate the validity of this claim, it’s essential to examine the nature of dependence and withdrawal associated with both SSRIs and heroin.

Understanding SSRIs and Their Discontinuation

SSRIs are a class of medications commonly prescribed to treat depression and anxiety disorders. They function by increasing serotonin levels in the brain, which can help improve mood. Common SSRIs include fluoxetine (Prozac), sertraline (Zoloft), and paroxetine (Paxil).

When patients decide to stop taking SSRIs, especially abruptly, they may experience what’s known as “antidepressant discontinuation syndrome.” Symptoms can include dizziness, nausea, headaches, fatigue, and flu-like sensations. While these symptoms are typically mild and transient, lasting a few weeks, they can be distressing. Notably, the occurrence and severity of discontinuation symptoms can vary depending on the specific SSRI and its half-life. For instance, paroxetine, which has a shorter half-life, is more commonly associated with discontinuation symptoms compared to fluoxetine, which has a longer half-life.

It’s crucial to distinguish between “dependence” and “addiction.” Dependence refers to the body’s physiological adaptation to a substance, leading to withdrawal symptoms upon cessation. Addiction, on the other hand, involves compulsive use of a substance despite harmful consequences. Experts emphasize that while discontinuation symptoms indicate physical dependence, SSRIs do not cause addiction. Dr. Smita Das from Stanford School of Medicine clarifies that decades of research indicate antidepressants do not lead to addiction.

Heroin and Its Withdrawal

Heroin, an opioid derived from morphine, is known for its high potential for addiction. It binds to mu-opioid receptors in the brain, producing intense euphoria and pain relief. Regular use leads to the development of tolerance (requiring more of the drug to achieve the same effect) and physical dependence.

Withdrawal from heroin is often severe and can include symptoms such as intense drug cravings, anxiety, nausea, vomiting, diarrhea, stomach cramps, fever, and increased heart rate. These symptoms can begin within hours of the last dose and may persist for days. The psychological aspects, such as anxiety and irritability, can last much longer. Due to the intensity of these symptoms, medical intervention is often required, utilizing medications like methadone or buprenorphine to ease the withdrawal process.

Comparing Discontinuation and Withdrawal

While both SSRIs and heroin can lead to withdrawal symptoms upon cessation, the nature, severity, and implications of these symptoms differ significantly.

• Severity and Duration: Heroin withdrawal symptoms are typically more intense and can be life-threatening, necessitating medical supervision. In contrast, SSRI discontinuation symptoms are generally milder and self-limiting.

• Addiction Potential: Heroin has a high potential for addiction, characterized by compulsive use and significant social, legal, and health consequences. SSRIs do not produce euphoria, cravings, or compulsive use behaviors associated with addiction.

• Management: Heroin withdrawal often requires structured medical detoxification and long-term treatment strategies. SSRI discontinuation can usually be managed by gradually tapering the dose under a physician’s guidance.

Expert Opinions

Medical professionals have weighed in on RFK Jr.’s claim. Dr. Smita Das emphasizes the importance of understanding the difference between dependence and addiction to avoid unnecessary confusion and distress among patients who rely on these medications.

Dr. Mark Horowitz, a clinical research fellow in psychiatry, has personal experience with antidepressant withdrawal. After facing severe withdrawal symptoms himself, he co-authored guidelines on safely discontinuing antidepressants. These guidelines recommend a more gradual dose reduction than previously advised to minimize withdrawal effects.

While discontinuing SSRIs can lead to withdrawal symptoms in some individuals, these symptoms are generally less severe and of shorter duration than those associated with heroin withdrawal. Moreover, SSRIs do not carry the addiction potential that heroin does. Therefore, the claim that antidepressants are tougher to quit than heroin lacks support from clinical evidence. Patients considering discontinuing SSRIs should consult with their healthcare providers to develop a safe and effective tapering plan tailored to their needs.