Author: HP McLovincraft

The Federal Government is the largest funder of mental health services and psychiatric drugs, yet these same federal agencies that provide mental health services do not provide any information for safely getting off the drugs. AbleChild believes that as the largest supplier of psychiatric drugs, the federal government should also provide an “Exit plan” for deprescribing psychiatric drugs.

Medicaid and Medicare Part D treat psychiatric drugs as “must-cover” commodities: federal rules require drug plans to cover all or nearly all antidepressants and antipsychotics as protected classes, ensuring easy access and steady revenue for manufacturers. With Medicaid alone, antipsychotics generated more than 73 million prescription claims and  more than 6 billion dollars in one year, accounting for roughly 9% of all Medicaid drug spending and 10% of prescriptions.

This federal psychiatric drug infrastructure is one-way: it is built to initiate and maintain long-term drug exposure. There is no parallel requirement that any prescriber, clinic, or health plan design a personalized Exit plan before starting any psychiatric medications, and no federal benefit category that funds slow, labor-intensive taper support the way it funds prescription refills.

Regulators acknowledge serious risks associated with too many of the psychiatric drugs. For example, the Food and Drug Administration’s, (FDA) black-box warnings on antidepressants note increased suicidality risk in children, teens, and young adults, and require close monitoring when treatment is started or doses are changed. Large reviews of antidepressant withdrawal find that discontinuation symptoms are common—An alarming body of meta-analyses and large-scale surveys consistently demonstrates that between one-third and nearly one-half of patients prescribed psychiatric drugs experience withdrawal effects, with a significant portion enduring severe and drawn-out symptoms. For many, these reactions are far more than discomfort—they include incapacitating dizziness, unrelenting nausea, jarring electric-shock sensations, agitation, and relentless insomnia, often rivaling or overwhelming the original condition that led to treatment.

Beyond these physical and psychological torments, the risks escalate further. Withdrawal can trigger waves of suicidal thoughts and behaviors, with evidence linking severe discontinuation—particularly of antidepressants and opioids—to suicide attempts and completed suicides. Research documents the strong association between withdrawal and heightened aggression or violence, whether due to direct drug effects, physical desperation, or drug-seeking behavior fueled by protracted suffering. These dangers are not rare complications—they are consequences faced by a non-trivial share of those attempting to discontinue psychiatric drugs, and their impact on patient safety, public health, and the justice system is profound and underacknowledged.

Yet despite clear evidence that stopping psychiatric drugs can be medically complex and dangerous, U.S. law does not guarantee access to slow tapers, compounding, or close follow-up, when patients want to come off the drugs. A few specialty guidelines now outline careful benzodiazepine tapers and warn against abrupt cessation, but they are advisory documents, not enforceable rights. In practice, patients are routinely placed on medications with known withdrawal syndromes, while being left to navigate the exit alone or with minimal support when they try to stop.

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