RFK Jr. plans to curb antidepressants, which he falsely compares to heroin
RFK Jr. plans to curb antidepressants, which he falsely compares to heroin
小罗伯特·肯尼迪计划限制抗抑郁药，并将其错误地比作海洛因
In a brief appearance at a Make America Healthy Again Institute event Monday, anti-vaccine Health Secretary Robert F. Kennedy Jr. announced new federal initiatives to curb prescribing of antidepressants, which he has long attacked with false and dangerous claims. Mental health experts have previously condemned his rhetoric and are already pushing back on his new efforts. 周一，在“让美国再次健康研究所”（Make America Healthy Again Institute）举办的一场活动中，反疫苗立场的卫生部长小罗伯特·肯尼迪（Robert F. Kennedy Jr.）简短露面，并宣布了旨在限制抗抑郁药处方的新联邦举措。长期以来，他一直利用虚假且危险的言论攻击此类药物。心理健康专家此前已谴责过他的言论，并已开始对他的新举措进行反击。
The MAHA event was focused on “overmedicalization,” with participants broadly alleging—without evidence—that too many Americans, particularly youths, are overprescribed antidepressants in the class of selective serotonin reuptake inhibitors, or SSRIs. This class includes common medications such as Zoloft, Prozac, Paxil, and Lexapro, which are used to treat depression, anxiety, and post-traumatic stress disorder, among other conditions. Event participants focused on claims that the drugs are prescribed without informed consent, are harmful, and can be difficult to stop taking. 此次活动聚焦于“过度医疗化”问题，与会者在没有证据的情况下广泛声称，太多的美国人（尤其是青少年）被过度开具了选择性5-羟色胺再摄取抑制剂（SSRIs）类抗抑郁药。该类药物包括左洛复（Zoloft）、百忧解（Prozac）、帕罗西汀（Paxil）和来士普（Lexapro）等常用药，用于治疗抑郁症、焦虑症、创伤后应激障碍等疾病。与会者重点强调了这些药物在未经知情同意的情况下被开具、具有危害性且难以停药的说法。
False claims
虚假主张
The topics closely echo Kennedy’s claims. Among his many dangerous, evidence-free statements, he has suggested that too many people, including children, are put on SSRIs and that they make people violent. He has even suggested that they are the cause of mass shootings, including school shootings. In a podcast last year, he made the heinous claim that “every Black kid is now just standard put on Adderall, SSRIs, benzos, which are known to induce violence.” His suggested solution is for black children to be “reparented” and work on farms. 这些议题与肯尼迪的言论如出一辙。在他许多危险且缺乏证据的言论中，他曾暗示包括儿童在内的太多人被要求服用SSRIs，并称这些药物会使人变得暴力。他甚至暗示这些药物是包括校园枪击案在内的大规模枪击事件的诱因。在去年的一档播客中，他发表了令人发指的言论，称“现在每个黑人孩子都被标准地要求服用阿得拉（Adderall）、SSRIs和苯二氮卓类药物，而这些药物已知会诱发暴力。”他提出的解决方案是让黑人儿童接受“重新教养”并去农场工作。
Kennedy has also repeatedly made the false claim that quitting antidepressants is extremely difficult, harder to quit than heroin. But experts have debunked the claim—there is no research to back the suggestion. When Kennedy repeated it in his confirmation hearing in January 2025, Keith Humphreys, who studies addiction at Stanford University, emphasized to NPR that antidepressants and heroin “are in different universes when it comes to addiction risk.” “In my 35 years in the addiction field, I’ve met only two or three people who thought they were addicted to antidepressants versus thousands who were addicted to heroin and other opioids,” Humphreys said. 肯尼迪还多次错误地声称，戒断抗抑郁药极其困难，比戒掉海洛因还要难。但专家们已经驳斥了这一说法——没有任何研究支持这一观点。当肯尼迪在2025年1月的提名确认听证会上重申此观点时，斯坦福大学的成瘾研究专家基思·汉弗莱斯（Keith Humphreys）向美国国家公共电台（NPR）强调，抗抑郁药和海洛因在“成瘾风险方面完全处于不同的世界”。汉弗莱斯说：“在我从事成瘾研究的35年里，我只见过两三个人认为自己对抗抑郁药上瘾，而见过成千上万的人对海洛因和其他阿片类药物上瘾。”
Risky rhetoric
危险的言论
Stopping the drugs can lead to withdrawal-like symptoms and should be done in stages under the guidance of a doctor, but only a fraction of people experience these symptoms. A 2024 study in The Lancet estimated that about 15 percent, roughly 1 in 6, will have any symptoms from discontinuation, while only 3 percent, or about 1 in 35, will have symptoms classified as severe. 停药可能会导致类似戒断的症状，因此应在医生的指导下分阶段进行，但只有少数人会出现这些症状。《柳叶刀》2024年的一项研究估计，约有15%（大约六分之一）的人在停药后会出现任何症状，而只有3%（大约三十五分之一）的人会出现被归类为严重的症状。
In the daylong MAHA event on Monday, Kennedy spoke for less than 15 minutes but repeated his false claim about SSRIs and heroin, despite noting that it had been debunked after his confirmation hearing by fact checks and experts. “The New York Times and a lot of other outlets published a response from that saying that the experts disagreed with the secretary,” Kennedy said. “And we all know that whenever they say ‘trust the experts,’ they got nothing.” Kennedy instead relied on anecdotes of being a heroin addict himself for more than a decade and having a family member who he claimed was suicidal after stopping an SSRI. 在周一为期一天的MAHA活动中，肯尼迪发言不到15分钟，却再次重复了他关于SSRIs和海洛因的虚假主张，尽管他提到在提名确认听证会后，这一说法已被事实核查和专家驳斥。“《纽约时报》和其他许多媒体发表了回应，称专家们不同意部长的观点，”肯尼迪说，“我们都知道，每当他们说‘相信专家’时，他们其实什么都没有。”相反，肯尼迪依赖于他自己曾有十多年海洛因成瘾史的轶事，以及他声称的一位在停用SSRIs后产生自杀倾向的家庭成员的经历。
Experts have warned that Kennedy’s anecdotes, false claims, and dark messaging are dangerous—and, according to some research, potentially deadly. A 2024 study in Health Affairs found that the wording and media amplification of a safety warning about antidepressants from the Food and Drug Administration in 2003 may have led to thousands of deaths. The warning was intended to increase monitoring of suicidal thoughts, but instead was linked to “unintended reductions in physician visits for depression, depression diagnoses, antidepressant treatment and use, and psychotherapy visits, as well as increases in psychotropic drug poisonings and increased suicide deaths.” 专家们警告说，肯尼迪的轶事、虚假主张和阴暗的言论是危险的，根据一些研究，甚至可能是致命的。《健康事务》（Health Affairs）2024年的一项研究发现，美国食品药品监督管理局（FDA）在2003年发布的一项关于抗抑郁药的安全警告，其措辞和媒体的放大效应可能导致了数千人死亡。该警告本意是加强对自杀念头的监测，但结果却导致了“医生抑郁症就诊次数、抑郁症诊断、抗抑郁药治疗和使用以及心理治疗次数的非预期减少，同时也导致了精神药物中毒和自杀死亡人数的增加。”
“We strongly object”
“我们强烈反对”
In January, two of the co-authors of that 2024 Health Affairs study wrote an opinion piece in Stat News warning of the dangers of Kennedy’s messaging around SSRIs, saying, “[It’s] going to cost lives. The similarity to his anti-vaccine chatter is clear: When you bad-mouth effective, lifesaving vaccines, you end up driving people away from lifesaving medical care.” 今年1月，那项2024年《健康事务》研究的两名合著者在《Stat News》上撰写了一篇评论文章，警告肯尼迪关于SSRIs言论的危险性，称：“这将会付出生命的代价。这与他反疫苗的言论如出一辙：当你诋毁有效的、救命的疫苗时，最终会把人们推离救命的医疗护理。”
But Kennedy is moving beyond just disparaging SSRIs, unveiling on Monday several steps the federal government is taking to discourage their use. That includes training for clinicians and a Dear Colleague Letter that encourages health care providers to consider non-medical alternatives for treating mental health conditions—such as exercise, nutrition, and therapy—while emphasizing the risks and benefits of medications. The Centers for Medicare & Medicaid Services (CMS) also released guidance to health care providers on how to de-prescribe the drugs for patients. The guidance includes a new billing code for providers to get paid more easily for stepping patients off the drugs. 但肯尼迪的行动已不仅限于诋毁SSRIs，他在周一公布了联邦政府为抑制这些药物使用而采取的几项措施。其中包括对临床医生的培训，以及一封致同事信（Dear Colleague Letter），鼓励医疗服务提供者考虑治疗心理健康状况的非药物替代方案（如运动、营养和心理治疗），同时强调药物的风险和益处。美国医疗保险和医疗补助服务中心（CMS）也向医疗服务提供者发布了关于如何为患者停止开具此类药物的指南。该指南包括一个新的计费代码，以便医疗提供者能更轻松地因帮助患者停药而获得报酬。
The moves have already gathered criticism from medical groups, who were not consulted on the new steps or involved with the MAHA event. In a statement, the American Psychiatric Association said that it “welcomes the attention placed squarely on the nation’s mental health crisis.” But, “we strongly object to framing the nation’s mental health crisis as primarily a problem of ‘overmedicalization’ or ‘overprescribing,’” the association said. That characterization oversimplifies a complex crisis and ignores the larger reality: too many patients cannot access timely, comprehensive care, while care remains unevenly distributed across our health system. … Deprescribing alone is not a sufficient response to this crisis. In psychiatry, as in all areas of medicine, prescribing and deprescribing occur every day as part of individualized, evidence-based treatment planning between physicians and patients. 这些举措已经招致了医疗团体的批评，他们并未就这些新步骤进行过咨询，也未参与MAHA的活动。美国精神病学协会在一份声明中表示，它“欢迎各界将注意力集中在国家的心理健康危机上”。但该协会表示：“我们强烈反对将国家的心理健康危机主要归结为‘过度医疗化’或‘过度开药’的问题。”这种定性过度简化了一个复杂的危机，并忽视了更大的现实：太多的患者无法获得及时、全面的护理，而护理在我们的医疗系统中分布不均。……仅靠停止开药不足以应对这场危机。在精神病学中，正如在所有医学领域一样，开药和停药每天都在发生，这是医生与患者之间个性化、循证治疗计划的一部分。