What RFK Jr. Got Right (and Wrong) About Deprescribing

RFK Jr. and HHS have launched a deprescribing campaign, and the Refrigerator Moms have thoughts. Julianna and Kelley agree that psychiatric medication, especially for kids and teens, is often over prescribed. But they push back on what's actually being offered as a solution: fast-tracked psychedelic medication, while non-invasive, drug-free options like TMS go unmentioned. They dig into who's prescribing SSRIs (it's not just psychiatrists), what's missing from the conversation about alcohol and legalized cannabis interacting with medication, and why a real deprescribing conversation needs to include real alternatives, not just a new drug.

Key Takeaways:

• RFK Jr. and HHS have started a deprescribing campaign for psychiatric medication
• Julianna and Kelley agree overprescribing is real, especially for children and adolescents
• The campaign's main alternative appears to be fast-tracked psychedelic medication
• TMS, a non-invasive, drug-free option, is largely absent from the public conversation
• TMS is currently covered by insurance for ages 15 and up
• About 40% of SSRIs are prescribed by general practitioners, not psychiatrists
• Legalized cannabis and its interaction with SSRIs remains understudied
• Psychiatrists often lack education about alternatives like TMS and can act as gatekeepers
• TMS is also FDA cleared for smoking cessation, relevant given rising vaping rates
• The hosts want a real conversation about alternatives, not a surface-level one

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Refrigerator Moms is sponsored by Brain Performance Technologies, a specialty mental health clinic that offers neuromodulation treatments for mental health conditions including depression, PTSD, OCD, anxiety, ADHD and autism. Our treatments utilize transcranial magnetic stimulation (TMS) protocols including rTMS, aTMS, and MeRT. All of our treatments are drug-free and noninvasive. Call for insurance options or learn more at https://brainperformancetechnologies.com

00:00 RFK Jr.'s deprescribing campaign begins
00:18 Welcome and today's topic
00:27 Their Dear RFK letter on the website
01:00 Where they agree with RFK Jr.
01:23 Psychedelic medication is the proposed fix
01:49 Concerns about disassociative drugs for kids
02:11 Revisiting their prior medication episode
02:40 Are SSRIs studied in combination with other drugs
02:56 The big question: what are the alternatives
03:26 TMS is missing from the deprescribing conversation
03:49 Searching news comments for TMS mentions
04:28 TMS insurance coverage starts at age 15
05:07 General practitioners prescribe 40% of SSRIs
05:52 A surface-level conversation isn't enough
06:01 Sponsor: Brain Performance Technologies
06:33 What "prescribed correctly" really means
06:55 Legal cannabis and SSRIs, an understudied mix
07:40 TMS is FDA cleared for smoking cessation
08:06 Is RFK Jr. having this conversation in earnest
08:35 Overprescribing is real, but so is the need for alternatives
09:14 Closing thoughts and how to support the show