Mark Horowitz: My Own Withdrawal Rewrote the Science Behind Hyperbolic Tapering

What if the hardest part of coming off an antidepressant isn’t the first cut, but the last milligrams? We sit down with Dr. Mark Horowitz—clinician, researcher, and someone who’s been through withdrawal himself—to unravel why standard advice fails, how the brain adapts to medication, and what a safer exit really looks like.

Mark shares his first taper attempt after 13 years on Lexapro, a methodical plan that still crashed into panic, derealization, and hours of daily terror. That lived shock led him to survivingantidepressants.org, hyperbolic tapering, and ultimately co-authoring the Maudsley Deprescribing Guidelines and national guidance in the UK. We dig into the science behind tolerance and homeostasis, the neuroimaging that explains why tiny doses can have big effects, and the practical tools—liquid formulations and small percentage reductions—that let people step down without falling off a cliff.

We also take on the evidence base. Most psychiatric drug trials are short, yet millions stay on meds for years. Stopping studies often confuse withdrawal with relapse, inflating claims for maintenance. Mark clarifies the dif

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💊 Ready to Deprescribe Your Psych Meds?

Psych meds have harmed us—and we’re not just survivors, we’re deeply educated in psychopharmacology, psychology, and nutrition. As hosts of The Gaslit Truth Podcast, we guide people safely off psychiatric medications with strategies grounded in science and brain health

🔥 You’ve been harmed. You’ve been dismissed. It’s time to take your brain back—with guidance from people who’ve been there and know their stuff.

Chapters

• 0:02 Hosts Introduce Deprescribing Mission
• 0:45 Welcoming Dr. Mark Horowitz
• 2:32 Mark’s Backstory As Doctor And Patient
• 5:28 First Taper Attempt And Severe Withdrawal
• 9:30 Hyperbolic Tapering And What Worked
• 12:18 From Forums To Published Guidelines
• 16:06 Why Patients Buy The Textbook
• 20:01 The Role Of Therapists In Deprescribing
• 24:24 Research Gaps And Biased Evidence
• 30:07 Dependence Versus Addiction Explained
• 37:54 Coping With Harm And Building Services
• 43:05 Why Clinicians Miss Withdrawal
• 48:39 “Psych Meds Save Lives” Claim Challenged
• 51:48 Signs Of Progress UK vs US
• 55:00 Practical Advice For Safer Tapers
• 56:02 Closing And Listener Support

Transcript

SPEAKER_03: 0:02

When it came to type ring psych meds, I took matters into my own hands rather than reloading on the prescribers, like so many other patients are forced to do. We are your whistleblowing shrinks, Dr. Terra Lin and Therapist Jen. But before we crack this wide open, hit like, smash, subscribe. And if you're on YouTube, ring that bell so you don't miss a thing.

SPEAKER_06: 0:21

And just remember, all of you who are out there and listening to the show, Dr. Terry and I are de-prescribers. We can help you get enough of your psychiatric medications safely for the brain and for the body. And so if you are interested in doing that, please make sure that you send us an email at thegastletruthpodcast at gmail.com. And it feels kind of crazy to say that statement in front of the presence of greatness of the like expert in deprescribing right now. Everybody, we have got to welcome Dr. Mark Horowitz to the show. Mark is a clinical research fellow in psychiatry with the National Health Service in England, a visiting lecturer at King's College in London, and a resident psychiatrist. He earned his PhD at King's College London, studying the neurobiology of depression and antidepressant action. Dr. Horowitz is the lead author of the Moudsley Deprescribing Guidelines, which underpin guidance on safely stopping psychiatric medication. He co-authored the Royal College of Psychiatrists Stopping Antidepressants Guidance, contributed to National Institute for Health and Care Excellence recommendations on tapering psychiatric medications. Mark has published extensively on safe deprescribing and leading journals, serves as an associate editor of therapeutic advances in psychopharmacology, and has helped develop NHS training and guidance on deprescribing. His personal experience coming off psychiatric medications has really strongly shaped the work that he does. Welcome to the show, Mark.

SPEAKER_00: 1:44

Thanks for having me on, Jen and Timmy. Thanks.

SPEAKER_03: 1:47

Yeah, we've been wanting this conversation for quite a long time.

SPEAKER_01: 1:55

And it's been used as not as a little bit of a little bit of a little bit of.

SPEAKER_05: 1:57

Yeah, but look at this.

SPEAKER_03: 1:59

Now, what you don't know about Jen, Mark, is that the DSM used to look like that for Jen. You just exchange them with the Mosley deep prescribing kind of land all tabbed up and ready to go. So thank you very much for that. That's a big benefit must be. All right, Mark. So we would, I know that you've said this story a million Jillian times, but hopefully somebody that we're listening to or listening to Mark's show maybe hasn't heard it. So what I would like to start off with, this the pieces that I'm curious is your personal story leading up to how you got to Maudsley, essentially. Like how did you get there? And then from that point, I've got some questions for you as well. So if you'd like to just get started with your personal story, that would be fantastic for our listeners.

SPEAKER_01: 2:54

Right. So I guess I guess there's two sides to my story. I, as, as Jen said, you know, I trained as went through medical school, trained as a psychiatrist in Australia, did some training in the UK, did a PhD in how antidepressants work and the neurobiology of depression. And of and I also had a second parallel career as a patient. I took antidepressants from my early 20s. I was not a happy camper back then. I I was I had very mixed feelings about the course that I was doing. Come from a complicated family, very like everyone else. And I was taking Lexapro from my early 20s until I finished off my PhD in London. So I just finished off PhD where I spent the entire time sort of looking down a microscope at cells in the brain to try to work out what's going on with depression and how antidepressants affected that. And at the end of that PhD, I read an article about withdrawal effects from antidepressants. And I found that to be quite startling. I hadn't heard about that before. And it gave me two main ideas. One, any drug that causes withdrawal effects also causes tolerance. The more you get accustomed to a drug, the harder it is to stop. You know, the more tolerant you are to caffeine, the harder it is to stop. And I thought, well, I've been on this drug now, Lexaproesetalopram, for 13 years. You know, could it still be doing anything if it's a drug that causes tolerance? Number one. And number two, drugs that cause withdrawal generally aren't that good for you. I knew that benzodiazepines like Xanax and Valium and opioids like oxycodone and street drugs cause withdrawal. And I thought those drugs tend to be toxic in the long term. So what have I been taking? So it was kind of a moment for me. I also had a lot of health problems while taking the drugs. I had severe fatigue and I had major issues with concentration and memory. And I'd and I'd received a variety of different diagnoses to explain that chronic fatigue syndrome and then narcolepsy. But I always had questions in my mind as to you know what's the cause of this. The diagnosis were always a little bit, you don't quite meet this, but you do have this. Yes, you're clearly very tired. And I wondered whether it might be the antidepressants. And so reading this article about withdrawal effects kind of triggered me to decide to try to come off the drugs. And I sort of and I decided to come off much more slowly than guidelines recommended. I had come across being a both a very you know nerdy and obsessive person and a geriatric millennial, I Googled to see, you know, what's what are people doing. And I found I found surviving antidepressants then before I came off the drugs. And I found a couple of things on that. One, a lot of other people who were on similar drugs were very tired, had concentration and memory problems. Some of them had been diagnosed with chronic fatigue syndrome and narcolepsy. And I thought, you know, oh my goodness, because I had spent you know years trying to work out what was going on. I'd be given a whole lot of other drugs along the way, stimulants, you know, uppers, downers, kind of sleeping tablets. So I, you know, I really had been trying very hard to solve that problem. So that was a real kind of red flag. And I decided, I sort of decided, oh, people coming off over these drugs over years, you know, that's that's a bit extreme, but I'll come off slower than the guidelines recommend. And so I came off over a few months. I was working in a kind of world-class molecular biology labor laboratory. So I used, you know, micropipettes and weighing machines, you know, I went above and beyond. I thought I was being extremely careful. I got a liquid version of the drug, and I went down from I think 15 milligrams of Lexapro to one milligram over four months, which was way slower than guidelines, you know, that most people do. And at things got rocky, you know, in the last couple of milligrams, but at a milligram, you know, my life kind of fell to pieces. I had trouble sleeping, and when I woke up in the mornings, it was to full-blown panic. I felt like I was being chased by a wild animal, you know, standing on the edge of a cliff. I would have sweaty palms, you know, a beating heart, and I would feel this utter sense of terror. You know, I kind of, since learning more about it, I think I had a kind of mild to moderate acophysia type symptoms. It wasn't, I wasn't pacing, but I did take up running to try to sort of burn off all this excess energy. And I was in this state of panic for about nine or ten hours of the day. I get more relief in the evenings, but I would sort of have a bit of, you know, a little bit of calm. But for most of the day, I was in sort of you know, full-blown panic, terror. You know, things also appeared a bit unreal to me. I had derealization, depersonalization, and I was a bit dizzy. And I crawled through those weeks. I was still working, you know, but I was basically, you know, going to the bathroom, close to tears, you know, trying to kind of hold it together. You know, after a few weeks of that, because I sort of thought, you know, this drug maybe is causing all these health problems, you know, and I should say the health problems caused me to work part-time, they had a huge effect on my relationships. I thought, I don't go back on a drug that's causing me all this trouble, but being down on this at this low dose, you know, is almost unbearable. I tried to hold on for a few weeks and I just thought, you know, if I hold on like this, I don't know that I'll survive. I'm not, you know, I don't think I can live like this. And I eventually went, you know, up slowly back to, you know, I think back to 10 or 15 milligrams, my normal dose. And luckily for me, and I realise it doesn't happen for everybody, my symptoms resolved over the next few weeks. But I was utterly shattered by that experience. It was definitely the scariest thing I've been through. I ended up actually moving back from London, where I was then living, to my parents' house in Australia. I sort of came back with my tail between my legs in my mid-30s, you know, an ostensibly grown man, but kind of on my knees. And I basically put that to the back of my mind for a couple of years. I went back to psychiatry training and I decided then to cut a long story short, to come off again. And I went back to surviving antidepressants. I thought that's the place that's given me the most, you know, understanding of what I've gone through. I could see that it wasn't in the papers and lectures that I was attending for psychiatry. And so I followed their guidance this time. This time I didn't think I was cleverer than the average bear. I went down at around 10% per month, you know, using a liquid. And I guess that worked a lot better. And it took me years to come off. I was then on multiple drugs. It took me years to come off, not weeks. And the symptoms that I had whilst on the drugs, that fatigue, the memory and concentration problems started to resolve. And I just sort of thought, you know, this is utterly, you know, bizarre. I have I had at that point six academic degrees in medicine, science, and psychiatry. But I was getting advice on how to come off these drugs from a retired software engineer, you know, uh, homemakers, truck drivers who give me better advice than you know the top people in the field that I had done my PhD with. I thought, you know, this is quite perverse. And so, you know, good little uh nerd that I am, I decided to write an academic paper about it. And I and I that's my that's my response to uh to try. Um I wrote an article about you know what I'd learnt from these from surviving antidepressants mostly. You know, they they even they had they even on that on those pages I had some neuroimaging that really made sense of why it was so hard to come off the last few milligrams of the drug.

SPEAKER_03: 10:14

Your own neuroimaging or neuro okay, so of others, okay.

SPEAKER_01: 10:18

Studies done in the 2000s by a group at Harvard where they basically put people in the scanner who had taken different doses of antidepressants and they traced out, you know, probably it's now quite familiar, curves where very low doses of the drug have much larger effects. They sort of captured in a very easy, easy to see way why small doses of the drug are so hard to come off. And so I put this into a paper with you know with some academic explanations. You know, it was published in a very good journal in Europe, The Last of Psychiatry. And, you know, I guess the first response from the establishment in psychiatry was to write a letter to say this is total nonsense, doctors know what they're doing. You know, what happens between a patient and a doctor in the you know, the quiet of their consulting room is no business of whoever this guy is, you know, basically the message was step back, you know, we're the professionals, you don't know what you're talking about. And that was, I mean, that was a red rag to a bull for me, because if they had said, oh, this is very interesting, you know, we'll probably put this into our into our practice. Thank you, that's very useful. I would have probably gone back to regular practice and back to Australia and just continued my career. But the fact that that was the response of the kind of the big professors at the major unit, you know, the big Ivy League equivalent universities in the UK, I found so upsetting and enraging. I remember getting, I remember getting the email when I was in a library and just sort of you know almost you know you know kicked off in the middle of the library.

SPEAKER_04: 11:44

He was napping quiet, everybody who's losing a shit in the library.

SPEAKER_01: 11:48

Right. There's a guy, there's a guy, there's a very nerdy guy with thick glasses screaming in the library. Um we've got a problem here. And I guess the last that set off the last six years, where I have suspended my training for the last few years and basically dedicated myself full time to researching how to come off drugs, trying to communicate it to other doctors. You know, I've I've I've gone around the world lecturing, I've written multiple papers, you know, and that I guess culminated in writing the more CD prescribing guidelines to try to put you know what I'd learnt as much as possible. There's I think there's lots of limitations to the book, but but to put as much as as I could, you know, in a book that a clinician could use to guide them to get people off drugs in a safer way than they had probably been taught in their training. And that's you know, I guess that's where the book came from. And I and I sorry, you you mentioned the DSM at the beginning of this talk. Now, as it happens on Amazon, in the psychiatry category in America, the only book that's selling more than the Morbit prescribing guidelines is the DSM. So this is but I gotta say, you know, I I don't know if it's it's not sure if it's distressing, but you know, as it happens, a lot of people that have bought the book are patients. So there's been kind of quite a you know, some way that's quite perverse. The patients are buying this book to give to their doctors. You know, I don't think that normally happens in medical education that a patient you know buys a medical textbook for their doctors. I think that just really shows you know how behind you know the medical field is on this topic.

SPEAKER_06: 13:19

I've done it true.

SPEAKER_03: 13:20

I mean, I handed it to my people. But wait, hold on. I think in, and this is just my my thoughts. I think in the United States the DSM is also being bought by the gender population. Yeah. Because there's such a push for people to self-diagnose and want diagnosing and all like they're just like intrigued by diagnostics of mental health disorders, in at least in the United States. So I would argue that it's a good question. I didn't think of that. Yeah.

SPEAKER_06: 13:51

You can flap evidence based on anything and people flock to it, even though they don't take the time to actually understand the etiology of the DSM, how many of those diagnoses in there were actually based in science and the other 80 that were added on many years ago because of pressures of the head dude that was put in that book together, right? Like they don't know all of that. But in the United States, there is this huge tendency to self-diagnose. It becomes people's identities, it becomes their handles on their Facebook page, their ex page, their like that's you know, hi, I'm bipolar too, forever heart, you know, and and and so that's such a big piece here. So it it's that it's one thing I told you. I we tried to burn Mars, Mark.

SPEAKER_00: 14:38

It's very thick, it's very thick in blocking ones.

SPEAKER_06: 14:41

It's mixing.

SPEAKER_03: 14:42

It doesn't burn well.

SPEAKER_06: 14:43

It doesn't burn well. I mean, it's really it probably sounds really funny coming from two therapists. I mean, we are two clinicians who the basis of what we learned is diagnosing. And we have just decided that that's all kinds of hokum and you know, so but that that's I think the little piece piece of the the pie there.

SPEAKER_03: 15:01

So I would so as long as we're talking about therapists, um what are your thoughts on how therapists can help with this deprescribing kind of movement that's that's coming in here? Because I feel like therapists are often left out of the conversation entirely still. And I'm like, I Jen and I, as therapists, we're like therapists, we believe should be well in the conversation. So, what are your thoughts about the role of a therapist in this conversation?

SPEAKER_01: 15:31

Right, that's a great question. So there's a there's a a therapist in in England called Anne Guy who wrote a book on this topic aimed at therapists, you know, about about psychiatric drugs, use and withdrawal. And the main point she made, and I think it's a great one, is you know, therapists see patients more often than doctors do. They often know them better. So they are in a position to you know educate people about the effects of drugs and the effects of coming off the drugs. Okay, it might not be I don't know what all the licensing rules are in America, but in England, psychologists don't prescribe medications and they can't stop medications. Don't hear either.

SPEAKER_04: 16:06

Same. It's the same here.

SPEAKER_01: 16:08

I don't prescribe, but we could definitely educate. Exactly. So so even, you know, so there's sort of an implicit message, you know, this is doctor's territory, step back. But you know, it might not not be that you're giving medical advice that you should stop this medication or you should increase this medication or whatever it is, but medical information is given by you know every website on the internet that this is what you could look for if you have an antibiotic, what an what a side effect looks like. And so I think therapists are in an excellent position to give information that's relevant to a patient. So, you know, if someone comes in and says, I've just stopped my drug and I feel absolutely awful, you know, it's clear that I need the drug and going back to my doctor to get a refill. You know, that's an opportunity to educate somebody about the fact that there are withdrawal effects, that feeling terrible on coming off a drug isn't necessarily a sign of a return of an underlying condition. It may be there'll be withdrawal. Here are some characteristics of withdrawal compared to relapse. So I think there's lots of opportunities for therapists to offer very useful information.

SPEAKER_06: 17:04

Psychoeducation. We are a hub of psychoeducation for so many things, right? I mean, truly, whether it's sleep or nutrition or cognitive things going on, right? Like try, like we we're constantly educating our clients.

SPEAKER_01: 17:21

Exactly. Yes. I mean, it makes total sense. It would be silly if you if you weren't. You've got such an opportunity there, you've got people that you see maybe weekly, doctors might be seeing them every three months. You know, you're probably more able to notice if someone starts a medication, what changes do they show, you know, physically or psychologically, you know, and you don't have to say, you're not you might not be in a position to say you should stop this drug or this drug is bad for you, or making some kind of judgment, but saying, you know, it is very common that on starting an antidepressant, you can feel emotionally numbed, you can be nauseous, you can be tired. These are things to discuss with your doctor.

SPEAKER_03: 17:54

I'm losing my mind because I'm like, actually, though, therapists can say things like that when it comes to cigarettes, alcohol, street drugs, all those other things. Like, this is bad for you, and this is the reason why it's bad for you. So I'm like, to me, that's such a parallel conversation. Not that you're an addict, right? Because that's not what we're talking about, but the idea that we can actually say, like, these things can be bad for you, and this is why, you know, I think is part of that conversation too.

SPEAKER_01: 18:25

You know, it could be, you know, you're not so you know, obviously, the manufacturers of the drugs talk about all the ways that the drugs can be bad for you, all the different adverse effects. So to pull out, you know, I think that's a very powerful intervention to pull out, you know, the little um patient insert inside the drugs to pull out, you know, the symptoms you're having, they're listed here, they're very common. You know, I think that's a very useful thing. Doctors often don't have time or or have been taught to sort of downplay those issues. So I think there are lots of ways that therapists can point people towards useful sources of information that that can that can you know make big differences in their lives.

SPEAKER_03: 18:59

Yeah. What when you were talking about the research that you were doing, because you it obviously most research is most thesis and and uh or hypothesis are developed over something that you have great interest in for most researchers. They have some interest in there. Now, what do you think the biggest research gaps might be? Because there has been a lot of research, but there's still gaps in the research. So, what do you think those gaps might be?

SPEAKER_01: 19:24

Right. I think I think the you know, the gaps are bigger than the research. So I I wouldn't be as charitable as you're being about the research. I mean, you know, you know, mostly, I mean, you know, most of psychiatry is based on studies that go for eight to twelve weeks. You know, the new drugs are now being approved after four weeks of of giving them to patients. You know, the average patient in America taking antidepressants as the kind of most commonly used drug, you know, there's now 25 million people in America that use the drugs for more than two years. I think it's not that much less that use them for more than five years. You know, what you can tell from eight weeks of a study compared to what happens if you use them for years and decades, the gap between that is immense. So, you know, you know, if you if you give somebody you know alcohol for a few weeks, they might be you know in quite a good mood, they might be quite relaxed, you don't see liver damage in a few weeks, you don't see you know cognitive damage in a few weeks. So it's a very we're using you know this tiny point of data to extrapolate to years and decades of use. I think that's why that's why so many doctors are convinced these drugs are safe and effective, because you look at this very narrow sliver of of data and use that to extrapolate to all use, which makes you know, is very implausible. You know, these studies are put all their effort into looking for benefits of the drug. You know, they will maybe use eight different uh rating scales to look for any benefit for anxiety or depression, and they kind of use you know what's called spontaneous reporting uh to detect adverse effects. So you have to come and tell us if you feel nauseous. You know, one senior colleague of mine says they look for benefits with a microscope and they look for side effects with a casual glance of the of the eye. So there's two very different you know levels of uh uh scrutiny provided to harms and benefits. So, you know, so most most use, you know, I would say is not evidence-based. You know, you could you could argue for eight weeks there's some very minor benefits and go into there's also major issues with those short-term studies. You know, they there's unblinding, people on the drugs know they're on the drugs, that will exaggerate the effects. There's publication bias. So studies that are negative, that don't show the drugs in a good light are not published. So there's we have a tiny little sliver of use that has been studied. It's studied in a way that is very biased by the manufacturers who run the studies. Then the second thing is you know, most guidelines that recommend long-term use of any sort of psychiatric drug, antidepressants, mood stabilizers, antipsychotics, are based on stopping studies. These are studies where they get people who are on antidepressants, for example, who are better, you know, less you know, not depressed anymore, and they randomize them to either continue the drug or stop the drug. And they show that people that stop the drug feel worse, and so they conclude you should continue the drug. And of course, I can see by your smiles that you know there's there's obvious trick there to ignore and withdrawal effects. Yes. We mentioned cigarettes, that with cigarettes, you stopped half people smoking and and let half keep smoking. You'd say, look, people that quit smoking become very irritable and anxious, so we should continue smoking in order to prevent anxiety and irritability. And that's it sort of sounds laughable that the same kind of technique.

SPEAKER_05: 22:42

Right, right.

SPEAKER_01: 22:44

To to recommend long-term treatment with psychic with psychiatric drugs, but that's what's happening. So, you know, in other words, uh the the evidence for long-term treatment is very, you know, is very poorly evidence-based. These studies are not well set up, and so I would say a lot of practice in psychiatry does not have strong evidence for it. And so there's there's much more. So the sort of studies that need to be done to kind of bring home these points is long-term comparisons between psychiatric drugs and placebo, you know, a two-year study, maybe a five-year study. Longitudinal so you can see what happens over time, you know, because to do that with alcohol, you know, you wouldn't see good outcomes in people given alcohol. Does the same sort of thing happen with antidepressants? Do the toxic effects, do the tolerance effects, do all the negative effects on sleep and concentration of sexuality outweigh any numbing benefits that people might get? And then to do the stopping studies in a more careful way, where the drugs are stopped very slowly, so there's not that withdrawal effects kind of messing up the system. And really, do drugs prevent relapse? I think it's a very big question. I think the answer is probably not. You know, cigarettes don't prevent relapse of anxiety. You know, I think it's very hard to tell exactly, but there are some analyses that have been done by some of my colleagues that suggest that mostly what antidepressants are doing is preventing antidepressant withdrawal. In other words, these things are not preventing relapse. And so I think, as I say, the holes are much bigger than the whatever is not the holes than the street drugs.

SPEAKER_03: 24:11

Yeah, I mean that that's like the dependence of street drugs. I know people hate it when I talk about this, but most people keep taking street drugs to avoid the withdrawal of the street drugs. So it to me, it's a that's a strong parallel comparison. People hate the talking about addiction that way independently. They hate these conversations, but there are some very strong parallels in those conversations that I think shouldn't be avoided personally. But, you know, and I I think some of the missing research itself is more, and people don't like this type of research either, more of the qualitative research studies versus just quantitative. People love numbers. Like they're like, let's assign numbers and get the numbers. And I'm like, let's study lived human experiences, let's study the site, lived psychology of people that are taking these medications and trying to taper from them. Like it, and I feel like all these podcasts that you've been on, and even our podcast is kind of like a study in progress because we are sharing those lived experiences out loud.

SPEAKER_06: 25:20

So here's the big question. I'm hearing tolerance, I'm hearing withdrawal, I'm hearing a relapse. How is this any different from addiction, Mark?

SPEAKER_01: 26:11

So I'm glad you asked that because it's it does confuse people. So, you know, this is it sort of sounds like an academic discussion, but I think it's worth having because it does confuse people. You know, there's addiction and there's physical dependence. And you know, you talk about street drugs, you know, people think about addiction. And I guess the key with addiction is there's things like compulsion, craving, people become obsessed with the drug, and there's often euphoria. You know, people are become addicted to drugs that give them this real reinforcement through euphoria. You know, and psychiatric drugs are often, although not always, different from that. You know, they don't they don't have the euphorion properties that are reinforcing like street drugs, but you don't need that for physical for physical dependence, tolerance and withdrawal. So, you know, an example would be something like caffeine. It's not a perfect example, but you know, most people in the community are using caffeine, you know, they're not getting very high off it. If they try to stop it, they get withdrawal effects. No one is injecting caffeine, no one is searching from their neighbors to get more caffeine. There's not, you know, there's not abuse, addiction as an issue. And the same is true for psychiatric drugs. You know, you don't need to be misusing antidepressants or benzodiazepines for tolerance to be happening. Tolerance is just what happens when you use a drug that affects the brain, you know, the process of homeostasis kicks in. Homeostasis is we want to stay in the middle. You know, if it's too hot outside, we sweat. If it's too cold outside, we shiver. If we're given a drug that that sort of ramps up serotonin levels, our body becomes less sensitive to serotonin and we become tolerant to the drug. And so all you need for withdrawal effects is that adaptation to the drug through homeostasis. And in in pharmacology textbooks, that's called physical dependence, which is distinct from addiction. But it's become conflated. It happens that the DSM3 committee thought the word addiction was pejorative, and so they use the word physical dependence. And because of that choice, it's really muddied the waters ever since. And so doctors use physical dependence and addiction as being interchangeable, and therefore they say, Well, antidepressants are not addictive, so they can't cause severe withdrawal. And that's why they and then using terms like discontinuation symptoms obscures it further. So doctors have this sort of there are the good drugs that cause discontinuation symptoms and not dependence, and then there are the naughty drugs that cause withdrawal symptoms and addiction. And of course, you know, the point is pharmacology, homeostasis applies to all drugs, whether they're prescribed by nice doctors or bad drug dealers. And I just I sort of also, you know, because sometimes doctors say, no, no, no, it's totally different. But for example, taking benzodiazepines, they can be addictive, but most people that use benzodiazepines, you know, do what their doctor says. I think, you know, 90% plus, and they get withdrawal symptoms when they stop. It's not a sign that they've been misusing it or that they're they're they're bad in some way, you know, and so the same process applies. You know, you don't need to be doing anything naughty, you don't need to be doing anything abusive for you to have withdrawal effects, and for those withdrawal effects to be so severe, you can't get off the drugs. So I think that's that is lost in all of this for a lot of doctors.

SPEAKER_03: 29:16

I think there's a there's a conversation here that you just kind of said about the difference between morality, like using using something in socially moral ways versus using something as prescribed, you know, that that is is moral, moral or immoral. Like you're like naughty, bad, good, you know, and I'm like, that's that's an interesting conversation because I I think that's where the argument is, isn't it? Like it in part is the moral, immoral discussions because people in with particularly benzodiazepines, right? They're like, well, I I am addicted. People general people use the term addicted if they don't, you know, dependence is the term that we use. They they use the term addicted, but I'm not misusing it. I'm not, I'm not selling it, I'm not doing the immoral things with it that someone who was actually addicted to it an addict would do, an addict would do. Like that feels like the differentiation here, which I think makes the distinguishment even further apart of the conversation.

SPEAKER_01: 30:21

I mean, I don't want to stick it, I don't want to stigmatize people that are addicted to substances. That's you know, but but I guess it is a different process. And I think you're right, there is sort of a moral judgment involved here. You know, what doctors prescribe, you know, that's ethical and that's that's that's by the book, and that can't cause dependence or withdrawal effects. It's what you do outside of the medical context that's what causes trouble. So there's sort of a bit of, you know, yes, a bit of a self-serving definition. You know, we can't cause withdrawal effects. Our drugs don't cause withdrawal effects. You know, we we cause discontinuation symptoms, which sounds very mild and underplayed. I do think there is that kind of semantics.

SPEAKER_06: 30:54

There's there's such a play on semantics within it. And Terry, Terry and I will go on social media and we we we'll blast about this one. I asked you this question, Mark, because I have di I have some different viewpoints of this, which is why I'm asking about it. And I'm like, we always have people on this show that we're we like never have a ton of debate, like intellectual debate within. And it's very interesting to hear you talk through that difference between what is considered like addiction and this this idea of dependence that that forms for people from from these drugs, okay, and the physical dependence. You're talking about euphoria, right? And these kind of pieces that go into like what addiction, if you were going to separate these two out a little bit, okay. Because as as somebody who has been on lexapro and is trying to get off of it and has been for 25 years, I will go on and talk about this. And people in the psych med-harmed community get very upset if you use the word addiction, okay? Because I will say, yes, like I am physiologically, I am addicted to this. I cannot get off of this. If I don't have it, you best bet I'm finding somebody who has lexapro, like when mine ran out, so I could go and crush one of their pills and put it in water because that has happened, right? All the behaviors, right? And they get really, really upset. And part of the reason why they get upset is because they have tied addiction in that word and the stigma of that word to this whole morality conversation. I'm not an addict. I I haven't left, like, I haven't drained my family's finances. I'm not robbing a liquor store to try to get like all the things that people, I'm not living in a vague elusive gym, which is a lot of people have lost their jobs during the election. My spouse hasn't left me. And I'm like all these, these like stigmatizing things that go along with that word. And sometimes I think there's such a semantics level to this because morality comes into play. And we're using these play play on words a little bit because addiction feels horrible. Like I'm not an addict.

SPEAKER_01: 32:53

I I guess, I guess there's also, I guess, you know, I I do disagree with you. I do agree with the people that that you know take the opposite perspective. The reason why is because addiction is a is sort of seen as a problem with the person. They've taken a substance and they've misused it and abused it. Yeah, so I've heard people talk about involuntary addiction as a way to kind of square up.

SPEAKER_06: 33:13

Okay. But I I can play on that one.

SPEAKER_01: 33:15

Yeah, I because it because it sort of implies then, because then the doctor writes down this patient has been abusing their medication, that's why they're in trouble. That's what that's what's implied. Yes, yes. But then it's kind of a it's a gen problem, not a lexapro problem. Yes. I'm saying it's a lexapro problem because you know, substance is dependence forming if your body responds to it, you know, to push against it with tolerance. And that's that's inherent to lexapro. It's not in here, you don't have to have a certain sort of personality or a certain sort of you know pattern of behavior. And that's I think there's a you're using the word we're using the word morality here, but I guess there's a responsibility aspect here as well. Sure. Abuse is sort of seen, although I won't get deep into you know uh issues on that, as a as a responsibility of the individual, which is probably also itself unfair. But I think dependence on psychiatric drugs, you know, is very much about the drugs, not the person. But I take your point. I've also got a senior colleague of mine who sort of you know gives me a hard time for this distinction. She says, you know, if you can't stop a drug you want to stop, you know, what's the word you use? It's addiction. So I kind of also understand that the common sense, you know, natural language use does make sense. I guess I stress this because if doctors hear the word addiction, they're thinking, you know, let's send you to a drug and alcohol center, let's send you, let's send you to 12-step programs. Yeah.

SPEAKER_03: 34:32

Which would never help anybody. It I would argue.

SPEAKER_06: 34:35

And that I'm on I can I can align with you on that one 100%. I like this again, it's kind of like I preach against the play on words, but yet the words you're using do matter. So it's I'm I'm circle talking myself. The involuntary addiction. Like that's that's I can get behind that for sure.

SPEAKER_01: 34:52

I don't I don't love that, but I I can see the value of it.

SPEAKER_05: 34:55

All right, we can do it in the middle, right? Like we don't have to agree, right? We like do not have to agree.

SPEAKER_03: 34:59

But you know, you know what's really interesting though is that so addiction, the word addiction does not appear in the DSM. Well, it does for a couple things. I think is or dependence is a gambling and something gambling and gaming, gambling and gaming, not for agreement and all the stuff, but it does appear in there for caffeine, like caffeine disorder. And I'm like, really, of all the things that can cause you problems, caffeine is in there, but but psych meds are not in that disorder because it's not a dis it's not a disorder of the person, it's a disorder of the drug. So how could they be in there? And also we know that the funding of the DSM, blah, blah, blah. But I I always find it very interesting that caffeine is something that's in there, and nobody talks about moral. I I was drinking a pot and a half of coffee every single day, and nobody said I was immoral, you know, and I I wouldn't have to like pillage people to get it, right?

SPEAKER_01: 36:34

Don't they use the word substance use disorder now? Isn't that isn't has that replaced addiction? Yeah. It did. Yes, it has.

SPEAKER_02: 36:41

Yep, substance use disorder.

SPEAKER_01: 36:43

So you can see here in that that you know, someone is is misusing their substances. So there is, you know, something someone's doing something wrong. So there is that there is kind of an implication of responsibility on the person, not the drug. Right, right, right. Yeah, right. It's not the best, yeah. That's why that's why I avoid that usage. Yeah, that's why we avoid the DSM, by the way.

SPEAKER_05: 37:02

That's why we tried to burn it, Mark. This is this is a whole circle right back to the beginning of this conversation, right?

SPEAKER_03: 37:07

But I I will say if someone in a lived experience, because I as someone who used Zoloft for six years myself, there was if I may ever ran out, if I couldn't get my prescription, I may went to a friend who gave it to me. I waited it out and I had withdrawals, and I was so irritable while I was using it. I at that time, I would say, I feel like an addict right now. Like I feel like I'm hosing for this to stem. You feel like an addict.

SPEAKER_06: 37:37

I mean, with all the syringes, I'm pulling every single night. I've got seven different syringes and I'm all the size, right? Like you, you do, you sit there and you're like, that's what it feels like.

SPEAKER_03: 37:47

Yeah.

SPEAKER_06: 37:48

Right.

SPEAKER_03: 37:49

And so when people talk about it, I don't, I also I take the idea that I'm I'm not going to dismiss their language because if that's how they feel, that's how they feel, right? So we'll talk, we'll talk through that in different ways.

unknown: 38:06

Right.

SPEAKER_03: 38:09

What keeps you, what do you think keeps you motivated to push this conversation forward in general about tapering and problems with research? Because we know it's it's hard to keep moving, talking the same thing over and over again as if nobody's listening. So, what keeps you motivated to keep pushing this conversation forward?

SPEAKER_01: 38:32

I mean, I think I think the I mean, I think there's two main things. One, there's so much harm being produced by not understanding this, and two, it's such a simple solution. You know, I I kind of, you know, there are you know, climate change involves rewiring the entire, you know, world, electricity grids, you know, huge problems. But all this requires, you know, is doctors giving patients some liquids and you tell them how to use a syringe, you know, informing them about the the risks of the drugs when they start them. This is such a simple, there's such a simple solution to this. And there's so much harm happening. You know, people lose their lives from withdrawal, they're disabled for years, protective withdrawal and PSSD means people's quality of life is you know utterly ruined. You know, I have, you know, I maybe you have similar inboxes, but I have one of the I think one of the worst inboxes you know in the world where all I get is a stream of people whose lives have been utterly ruined by going on or coming off these drugs, you know, and they're and their and their injury, you know, the insult is added because doctors say it's not the drugs, it's them. They can just come off in a few weeks, they can just halve tablets, they can just stop that way. Drugs couldn't do this, it couldn't still be the drug after several months. Drugs don't cause those symptoms, you couldn't be you know dizzy, you couldn't have, you know, if you have panic attacks, it must be your condition. So there's just huge amounts of harm caused by not understanding what are fairly simple things to understand. So I guess I'm you know, I keep on repeating myself again and again and again in the hope that doctors will take this up. You know, there's there's so many forms of resistance they have to this sort of information. Because, you know, what I sort of realized is every time I give a lecture to a group of, you know, I lecture in America, I lecture in the UK, I lecture in Australia, and I talk about all the things that we're talking about, you know, the cause of depression, ways of ways of solving it, the risks of the drugs, how to stop the drugs safely. And I realize that every time I give a lecture, they're getting 20 lectures from other professors of psychiatry saying the opposite.

SPEAKER_07: 40:33

Yes.

SPEAKER_01: 40:34

And I'm sort of hoping they're gonna listen to me, and sometimes a few of them do, but I also realize that they're being you know reinforced. You know, there are chemical imbalances, the drugs help, they're safe and effective. You know, withdrawal's not a big deal. You know, there's a few very voluble, angry patients that that are exaggerating these issues. You don't need to go through all this trouble. There's not randomized trials for hyperbolic tapering. So basically continue doing what you're doing, you know, and don't let that, don't let this this noise get in the way. And that's why I think there's so much trouble in getting this message out.

SPEAKER_06: 41:05

I I I want to ask you a question regarding what you just shared about your your inbox, right? And you're talking about like the information, the harm that you you you get that in intimate information from people. And Terry, I get we we get the same thing in our Gaslit Truths inbox once we started rolling here the amount of stories and the amount of harm that's in there. Okay. It's it's astronomical. How is it that you continue to be an advocate and balance that with what you've been through? Because I would venture to guess as you read some of these stories or you meet with people, because it's kind of cool when I get clients that'll come to me and they go, Yes, I've met with Mark Horowitz before.

SPEAKER_05: 41:49

And I'm like, beginning a little bit, just so you know. So, like you're you're first in the line, which is I'm cool with that. I'm actually totally cool with that. I'm like, yeah, good, because he's the expert. Like you went to the expert, really the expert.

SPEAKER_06: 42:02

But how do you how do you deal with that? Because I am guessing that there is a level, a ripple effect, almost of like vicarious trauma, almost, right? Because you're there's people that have stories that are really similar to yours. You've been there. Like you've been in those desperate spaces.

SPEAKER_01: 42:18

Yeah. I mean, I I I gotta say, I I think there is vicarious trauma. I find it quite upsetting to look in my inbox. I mean, I think one thing that I've done that has been helpful is I helped to set up a clinic in America called Outro Health. You know, that was because I got so many requests. I thought, you know, I can see a few people, you know, in the sort of academic consulting umbrella, but I can't help all these people, you know, I can't prescribe drugs for them. And so, you know, I was approached by some people that set up clinics in America, and I set up this clinic outro health so people can go to see qualified nurse practitioners, you know, and get led through the process because otherwise I feel like the scale of the problem is too big for me to handle, like I can't do it myself. And so I've had to engage others. I guess that's what drives me to educate other doctors because I can't stem you know this tide. You know, it is upsetting. I mean, I I you know the worst emails I get from are from people whose relatives have passed away from the process, you know, taken their lives or died. So, you know, it's it is it is not a pleasant inbox. And I hope, you know, I was hoping that one day it'll trickle down because there'll be a lot of other professionals doing this work and people will be caught before they get into trouble. I think that's another you know major issue that people don't understand. They're sort of I feel like they're walking on the edge of a cliff, and I'm sort of saying, don't go off too quickly, and they're saying, No, no, everyone tells me it's not a big cliff here, they jump, you know, and then it can be sometimes too late. If people are you know already in protective withdrawal, it's very hard to put them back together. You know, people do get better, don't want to be negative, but it's not easy. So I hope that if if every doctor is aware that coming off too quickly can cause people, you know, damage that can last for months and years, that that that can be avoided. So that's I guess why I'm so keen to you know put out a textbook, provide a clinic to help people come off and to educate other doctors so that people are not pushed off those cliffs.

SPEAKER_03: 44:07

Yeah, Jen and I have talked about a lot about how like sometimes I feel kind of re-traumatized or traumatized again by these stories because they are lengthy and they are powerful and they are so sad. Like there's such a great sadness in the things that people send you. It just so they could be heard, yeah, you know, and it's yeah.

SPEAKER_01: 44:32

I mean, sometimes I'm sort of seeing people and they're in a vicious cycle and they they're getting doctors giving them more medications to deal with withdrawal effects, and they're locked in and they can't get the right doses. And I, you know, it's just like this horrifying whirlwind, and the doctor's saying this can't be the drug. So I just, you know, to me, to me, the frustration is that you know, it's very hard to see what you haven't been trained to see. And I remember you know, I remember that I've I've I've walked the same corridors as other psychiatrists, and I didn't have any idea about withdrawal effects or all these profound effects of the drugs. And I've had flashbacks to you know, patients that I've seen that clearly had withdrawal effects that I was not aware of at the time. You know, I said acophysia, I remember presenting to the emergency department with you know suicidality, and I just like everybody else, I was like, this must be relapse, they need to put we need to put something back on the drug. So I don't blame my colleagues because you know, I I think there's this sense that patients have that there's something malicious in doctors, they're trying to, you know, they're they know the truth, but they're you know, they they don't admit it. I don't think that's true. You know, the average doctor is just following what they've been taught by their professors and their training. They've been taught, you know, they're they're I you know lots of my friends are doctors and psychiatrists, they're very well-meaning people, they're trying to help others, they've been taught these drugs are easy to come off, so they're not, you know, there's no maliciousness, I think. They just are you know not well informed, and that leads to all you know all of this trouble. That's why I hope it can be solved with education. Sorry, there's a bit of an echo now.

SPEAKER_06: 46:01

I think we had a little bit of a glitch going on from a little bit. I wonder yeah, there's a little glitch, guys. That's okay. I think we're I think we're back. Um what happens, Mark, when those individuals then have the awareness, have the information, it's given to them and it's dismissed. And I'm not trying to put you on the spot to be like like bashing your colleagues, right?

SPEAKER_03: 46:31

Like because doing that gives them makes us further and further apart from the truth and all the things.

SPEAKER_06: 46:36

So it's not it's not about that, but how that that's the part that it to me is I I don't I don't want to say unforgivable, but I can't seem to understand and wrap my brain around that part is when you actually have the information. Counselors do the same thing. We we we talk about this in our field as well, but you don't do anything with it and you just keep steering the course you were on.

SPEAKER_01: 46:58

I think there's a few reasons. I mean, one, I think to most, you know, psychiatrists or doctors, they don't see they they you know, they always tell me again, I don't see much withdrawal. And I kind of believe them because one, they don't take many people off their drugs. That's not part of their normal practice. If they do take someone off a drug, they're often switching to another drug or the person's already on multiple drugs. If a person has terrible trouble and the doctors told them that there'll be no trouble, sometimes patients get scared of their doctors and don't go back. So they don't get the loop is not closed because the patient runs off to a forum or to somebody else. So I kind of believe that doctors do not see much withdrawal because you know it's not that they're not they're not taking people off, they're not, they're not, it's not in front of them. And so then they hear me give a lecture and say it's very common, it's very severe, and they say that doesn't match my personal practice, you know, especially if they have dismissed all those people as having relapse. So I I kind of feel like I'm trying to convince people, you know, to see something that they haven't that they haven't that they haven't been taught to see. That's hard, that's hard for them to get their heads around. So I and I and I think there's cognitive dissonance, you know, they are mostly well-meaning people, they mostly, you know, they want to get home to their families and pay their mortgages, they mostly want to help people, that's why they got into the profession. They want a good at they want a salary as well, of course. I think to be told, you know, you're doing huge damage that what you're doing is maybe causing more harm than benefit. Lots of patients, I think it's very unpleasant to hear. And I would be, I would want to, you know, if I heard that message, I wouldn't like the the person carrying it. I would, I would, I'd rather shoot the messenger than shoot my you know, my colleagues. I think they also look, I think they also look around, you know, they think they sort of look around at each other and say, you know, is this, do you think this is, you know, and they sort of go, no, no, no, no, no. So there's a bit of kind of it would very be ups be greatly upsetting to the group, you know, to to face these things. So I think there's a lot of factors that push this away. And also they're given plausible deniability by studies that come out all the time. Yes. So the people that I blame the most, you know, are the academic leaders because I think they have much more insight into it. You know, there was a paper by CalFAS in Jammer Psychiatry a few months ago that basically said withdrawal is a minor thing. We've shown it in studies. You know, it was a very skewed study. It looked at short-term effects, it didn't, you know, it looked at studies that didn't look at these things closely. You know, to me it's a rubbish study, but it's in a very high-profile journal. And I've had lots of doctors say to me, Oh, it turns out it's not a big deal what you've been talking about. And, you know, so they've got something to justify their position. And so I sort of feel like they they're a little bit existing in a kind of stage-managed world, as I was. You know, they're shown these things, the drugs work, here are the short-term studies, they don't cause the draw, here are the short-term studies, and they kind of, you know, they want to believe that. I mean, if you're making your, you know, if you're if you're making your living based on these drugs, you want to think that they're good drugs because everyone wants to think that they're doing a good job. So I think there's all sorts of yes, cognitive dissonance, group think, kind of skewed experience that that makes it hard for people to take in this sort of message.

SPEAKER_03: 49:57

What do you say to people that say, well, you are fear-mongering because psychmeds save lives?

SPEAKER_01: 50:05

I mean, uh, well, the the question of whether they save lives is very, you know, is itself very under questioned. You know, that's most mostly given for antidepressants. You know, what what the double blind randomized controlled trials show is that antidepressants, you know, increase suicidality in young people, they have equivocal effects in in middle-aged people, and maybe, maybe there's some signs that in older people they're a bit protective, but there are other more recent analyses that say they probably increase suicidality across the board a little bit, so that it's not factually true to say that they're life-saving. Now, someone might feel in their lives that taking a drug that gave them some numbing or relief from their negative feelings might have been life-saving. That might be true for you know alcohol or going out and seeing friends, but in terms of you know, talking about evidence-based medicine, you know, the randomized controlled trials do not show that antidepressants are life-saving. So that's factually incorrect. Even if they were, that doesn't exclude that they can cause lots of trouble for people. And you know, they clearly are life-threatening and life-ending for some people because the withdrawal effects, I mean, I got there when I was coming off these drugs, you know, it was a life-threatening circumstance for me, the way the way I felt it certainly uh came close to that. So I, you know, so I I I think just because even it was true, it doesn't mean that harm is not an important issue to talk about when it affects so many different people.

SPEAKER_03: 51:31

Is there have you seen like hopeful signs of change?

SPEAKER_01: 51:34

Do you think that the I I I I sort of feel that the UK, you know, is several years, if not a decade, ahead of America. And I would say there are some small signs of change there. You know, the government has put out guidelines that has emphasized how severe withdrawal effects can be, people should come off more slowly. They talk a bit about hyperbolic tapering, not in as much detail as I think they should, but but something. You know, there are different bodies, educational bodies that are taking this up. I'm invited to talk a lot at a lot of different lectures. I would say there has been some uptake in terms of what happens on the ground. I'm not sure if it's there yet. I don't know if a lot of doctors are actually using liquids or using hyperbolic tapering, but it's definitely getting to that point where this is being discussed at a lot of different meetings and conferences. And I find that, you know, I find it slow, but a little bit heartening. I think America, you know, is a little bit whatever those monkeys with the hands over there is.

SPEAKER_03: 52:33

You know, yeah, that's that's funny because Jen and I our our original graphics were us doing that. The three monkeys. Yeah.

SPEAKER_01: 52:41

Okay. Yes, I gotta feel like I feel like all the ostrich putting its head in the sand. I feel like there's been you know a lot less progress in America, a lot more resistance to this. You know, I can kind of tell in the media, you know, there's probably been a thousand newspaper articles on this topic in the UK over the last five years, and there's been about five in America. You know, it's all become very complicated by RFK Jr., you know, I think I think his some of his views I think are you know fairly out there and and and not reality-based, but I think his views on psychiatric drugs are very sensible. But because you know the mainstream media has seen him sees him as a sort of crackpot, everything he says is in the crackpot, you know, group. And that means they've pushed even harder against issues about withdrawal because he's brought them up, I think, very credibly, which is unfortunate. I think that's made things even harder to get the message out there in America.

SPEAKER_03: 53:31

Interesting. All right. Well, do you have anything else that you would like to say to any of our listeners that you would think that they might find valuable or important?

SPEAKER_01: 53:45

I guess you know, I'd say to people to do their own research, to read about what these drugs do and ways to come off them, you know, to seek out people that know what they're doing, that have some sort of specialist qualification in deprescribing or or knowledge. You know, my textbook is around, outro health is around, people that know what they're doing because they've been through the process themselves and taken it up. So I, you know, I guess it's it's worth checking what your doctor says to make sure that you're doing the safest thing possible for you and these drugs, you know, can be very hard to come off, and and slower is better than quicker.

SPEAKER_06: 54:20

Yeah, I love that. Well, thank you, Mark, for for being here on the show. I I love the idea of what you said earlier about like it's kind of interesting how we can go to uh academia and it can't give us some of these answers, but yet the truck drivers and the homemakers of the world who are doing this, right? You know, like they're not walking around in the white coat, you know, with a triple board certified and all the things, right? Like, and I think that that's very, very a cool thing to hear because it it's that's where the start came from. And it is very real now. And we're bringing a lot of the some of the science in, right? It sounds like you guys are a little bit more advanced there than we are here, but that's cool. Like that really is. Like things think people people will say that to us a lot. Like, what's your degree? And we're like, we we don't have to have that. That part is very irrelevant to tell you that we can research and we can understand. And as a patient, all of us have been patients. We know the power of doing your own research.

SPEAKER_00: 55:18

Definitely.

SPEAKER_03: 55:19

It's good and listening to your body along the way, like like tuning in to yourself and not, you know, letting somebody else call all the shots for you. So that's right.

SPEAKER_06: 55:28

That's great. Well, everybody, as we wrap up here, we are the guestlet Truth Podcast finishing up here with Dr. Mark Horowitz. Mark, thank you for coming on the show. It's been an honor to have you on.

SPEAKER_00: 55:38

Thanks. Thanks. Thanks, everyone. Thanks for bringing attention to this issue. It's so important. Thanks for the being.

SPEAKER_06: 55:42

Absolutely. And for those of you that are still here, make sure that you get on and give us all the stars, all five stars, get on YouTube. Please subscribe to our channel and watch our stuff because you're gonna learn all about psychiatric drugs and psychiatric drug harm and what you can do about it. And once again, Mark, thanks for for being on the show.

SPEAKER_00: 55:58

Okay, thanks very much.