Deprescribing is up for debate.
Melancholia
One in six US adults takes antidepressants and a quarter have been on for 10+ years, with clear off-ramps lacking.
While the FDA requires randomized controlled trials to prove drug safety, it doesn’t mandate discontinuation trials — meaning tapering protocols don’t exist.
Complicating matters, a workforce shortage has made over half of US counties behavioral healthcare deserts. Without enough psychiatrists, 74% of antidepressants are prescribed by primary care doctors, who don’t have time for meaningful monitoring.
Frontiers
In May, the HHS announced a plan to curb “overprescribing,” calling for more nonpharmaceutical approaches like family support, psychotherapy, nutrition, and physical activity.
To help patients navigate the transition, ARPA-H is funding multimodal, longitudinal studies to uncover predictive markers and endpoints.
Roadmap. As neuroscience decodes the black box, the APA is updating the DSM—aka the “Bible of psychiatry”—for the first time since 2013 to factor biology, not just psychology.
Building an AI brain foundation model, Hemispheric emerged from stealth with $52M in July. Creating cognitive biomarkers, UniversalBrain’s EEG cap was FDA-cleared the same month.
Cutting trial and error, NeuroKaire uses blood tests to match patients with meds, Alto Neuroscience personalizes drugs to neurobiology, and Beacon Biosignals brings at-home EEG headbands into clinical trials.
Using wearables to uncover links, Amae Health enrolled Google to give patients Fitbits, UCSF’s Neuroscape tapped Samsung, and Oura’s supporting government-funded INVI MindHealth research on veterans.
Toolkit. Beyond clarifying SSRI endpoints, better brain data could point eligible patients toward alternative paths, especially for treatment-resistant cases.
Strategically partnering, Radial and psychedelics company Compass Pathways are exploring how tools like TMS, esketamine, and psilocybin will mix in the next-gen mental health clinic. Personalizing PTSD treatment, Wave got the FDA nod for biomarker-guided resonance therapy.
Measuring lifestyle’s impact, Meru’s whole-person digital model runs nutritional, hormonal, and inflammatory biomarkers to treat overlooked imbalances. Specializing in tapering, Outro Health takes a neuroscience-based approach to help patients discontinue meds safely.
Punchline: With new biometrics, predictive AI, and advanced interventions, precision psychiatry could drive more nuanced treatment paths — making SSRIs just one option in an expanding toolbox.
