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Imagine you’re a newly pregnant woman struggling with depression and anxiety. Like many women in your situation, you have for years been on antidepressants, and you have questions about what your pregnancy means for your treatment. Imagine, then, you turn to the Food and Drug Administration for help, hoping that this government agency would present you with the best available medical science, and the leading experts on that science, as you try to navigate a complicated medical question.
Under Health and Human Services Secretary Robert F. Kennedy’s revamped FDA, here’s what you get instead.
A panel, convened Monday to “challenge or defend current dogma” surrounding antidepressants and pregnancy, featuring the British author of a book titled Pharmageddon, hammering the supposed link between antidepressants and autism; another British scientist, calling in from Europe, insistent that antidepressants actually have no effect on depression; the owner of a private “tapering clinic” that charges patients tens of thousands of dollars to guide them through quitting psychiatric medications, asserting women sometimes struggle for years to come off antidepressants; and an anti-vaccine podcast host who has spoken of the value of depression as an “emotional experience.”
The panel focused specifically on SSRIs, or selective serotonin reuptake inhibitors, the specific category of drugs being debated. Common SSRIs include Prozac, Lexapro, and Zoloft, and they’re the most widely prescribed form of antidepressant in the U.S. According to the Cleveland Clinic, more than 1 in 10 Americans take some kind of antidepressant.
Of the 10 panelists, only one—the sole specialist in maternal mood disorders at the event—argued for SSRIs’ safety and value. The others insisted, with just as much of a sense of authority and certainty, that the medications were ineffective and that they caused miscarriages, hemorrhaging, autism, ADHD, cardiac birth defects, fetal alcohol syndrome, and other frightening outcomes.
For any pregnant woman tuning in or later hearing about the two-hour conversation, it would be hard to come away without a sense of confusion and anxiety about taking antidepressants.
Here’s the bottom line on pregnancy and antidepressants, according to that best available science and the experts on it: The risks of failing to treat an expecting mother’s depression far outweigh any risks from the medication itself.
The question of how SSRIs can affect pregnancy, childbirth, and fetal development is a complicated one that scientists believe deserves continued research and discussion. There are a few studies that show very rare risks of certain complications from SSRIs in pregnancy. And there is a more common condition in which babies become jittery, irritable, or have difficulty with sleeping or eating in the first few days after birth. Still, SSRIs are some of the most heavily studied medications for pregnant women, and the consensus is that they are safe.
“Robust evidence has shown that SSRIs are safe in pregnancy and that most do not increase the risk of birth defects,” the president of the American College of Obstetricians and Gynecologists said in a statement responding to the panel. “Unfortunately, the many outlandish and unfounded claims made by the panelists regarding SSRIs will only serve to incite fear and cause patients to come to false conclusions that could prevent them from getting the treatment they need.”
On the FDA panel, however, the discussion essentially buried that expert consensus under a barrage of misinformation, speculation, conspiracist theorizing, and pseudoscience. “Expertise” was a thing to be mistrusted, and the most qualified member of the panel—whose views reflected the scientific consensus—was both outnumbered and given no more weight than anyone else.
In RFK Jr.’s America—where the “Make America Healthy Again” movement is ascendant—the people deemed worth listening to are loud, angry, and confidently deluded.
According to the American College of Obstetricians and Gynecologists, mental health conditions are the most common cause of “pregnancy-related death,” largely because of overdoses, alcohol abuse, and suicide. But depression is still an issue for less extreme scenarios. Stress is known to be difficult on pregnancies—the ACOG statement mentioned depression putting patients at risk of preterm birth, preeclampsia, and low birth weight—and depression can often prevent pregnant women from getting proper medical care. Studies also show babies with mothers who struggle to bond can have developmental delays.
Instead of laying out the pros and cons with an explanation of the analytical methods by which the medical research community reached its current consensus, the FDA panel instead presented “world-renowned experts” who spoke only of alleged risks of SSRIs—risks based on flawed studies—and cast doubt on depression itself as a matter for medical concern. With just one voice of dissent on the panel, it seemed that the world’s experts were mostly in agreement that SSRIs were definitively dangerous. By mainstreaming fringe skeptics of modern medicine, the FDA clouded what has been, until this point, a clear consensus on the ultimate value of these medications.
This was something the FDA didn’t just platform but actively encourage: When the panel’s single pro-SSRI speaker argued that depression actually posed a greater threat to pregnant women and new mothers, the moderator called on one of the other panelists to respond because “you two have two very different points of view, and you’re both physicians”—portraying the two figures as being equally qualified to weigh in, even as the second actively spreads misinformation on social media about SSRIs’ link to autism.
The panel was part of Kennedy’s broader campaign to challenge SSRIs: FDA panels are indicators of where policy is likely to go. Kennedy, the secretary of Health and Human Services, sees them as a major symbol of the country’s overmedication. He also holds unscientific views of the drugs, having falsely claimed in the past that there is a link between antidepressants and school shootings and that they are more difficult to quit than heroin.
And in line with that broader mission, the misinformation went beyond the notion that SSRIs caused health issues in pregnancies, in ways that spoke to the instincts of the MAHA movement. One of the two British panelists, psychiatrist Joanna Moncrieff, used her time on the panel to emphasize that there was no evidence SSRIs did patients any good. Instead, she argued, they “alter” patients’ brain function akin to the way alcohol or opioids do, rather than helping with any underlying issue. This “emotional numbing” wasn’t actually helping anyone, she said. Similarly, David Healy, the other British psychiatrist, argued that depression should not be treated as a medical issue of concern because people tend to “recover spontaneously” from depressive episodes in a matter of weeks.
This approach to thinking about depression fits with the MAHA movement’s ideas about health and mental wellness. Typically, the doctors in this movement emphasize a “natural” approach to handling mood disorders, rather than an overly “medicalized” one. This approach emphasizes individual responsibility to improve your own mental well-being through exercise, diet, and self-empowerment—and, when that fails, learning to embrace the misery.
As one panelist, Dr. Roger McFillin, put it: “You’re describing emotional experiences. What has happened when we’ve medicalized all aspects of the human experience?”
McFillin, a psychologist in Bethlehem, Pennsylvania, argued that treating depression as an illness actually causes greater human suffering because it causes people to doubt their “own internal experiences” rather than learn from them. “Does anyone here believe that we evolved to feel pain and emotional distress, and that’s somehow a flaw in our genetic evolution?” he asked the panel. “I want to challenge people to have a different discussion, to see everything you experience as a signal, and a very important signal that if you don’t learn to pay attention to, you’ll surrender your autonomy … and you’re going to be dependent on the medical system.”
He then hit on another MAHA theme: a particularly reverent and patronizing idea of womanhood. Why, he asked, do women take SSRIs at a higher rate than men? Is it because women are more mentally ill? “Or are women just naturally experiencing their emotions more intensely?” he said. “And those are gifts.”
One key part of all these arguments is in the empowerment of the individual to take hold of their health—if they purchase the right homeopathic products, follow the right health influencers, or buy the right nutrition plans. They sell the notion of willpower and changing your thinking. It’s an individualistic approach utterly at odds with the population-level thinking of public health. And in that individualized approach, taking control of your own medical care means cutting out doctors—and therefore their medicines—who are products of a system in which patients are, necessarily, dependent on the doctor’s expertise. That leaves more basic solutions: diet, exercise, and strange, untested remedies.
Of course exercise, diet, self-empowerment, and other non-medicinal factors have a role in alleviating depression. But that’s reflected in the medical consensus, which recommends those things as a complement to tested and proven psychiatric treatments. And of course there’s room for humans to experience a full range of emotion, but that’s different from the medically dangerous condition of depression, which does not necessarily emerge as a response to a hardship and which can cause people to function poorly in day-to-day life. This kind of state of existence, in which it can be impossible to experience joy or interest in your favorite things, is one few would describe as healthy, much less a “gift” to women.
The experts the FDA brought in for its panel weren’t just any kind of SSRI critics. They were, in large part, people who had built personal brands around speaking “truths” about the institutions they operated in—or at the fringes of. And speaking at the FDA was not just a matter, for these figures, of challenging conventional dogmas, but of boosting their own reputations, sometimes to the benefit of their own finances and audiences.
McFillin hosts a podcast called Radically Genuine, in which he argues against mainstream psychiatric practices. Some of his episodes have dealt with a “vaccine-injured” doctor; detransitioners and the harm of transgender-affirming medical care; telepathy; and the “GERM THEORY LIE.”
He’s not the only podcaster of the group. Josef Witt-Doerring, the psychiatrist with the “tapering clinic” and a former FDA official, has 140,000 subscribers on YouTube. He has made videos about “The Benzodiazepine ‘Holocaust’ ”; “SSRI-Induced ‘Suicide’ ”; and the “10 MOST Dangerous Prescription Drugs.” The exchange of podcast appearances among this group is tight. Witt-Doerring hosted Moncrieff, Healy, and McFillin, as well as another panelist, Dr. Adam Urato, an obstetrician-gynecologist in Framingham, Massachusetts. McFillin hosted Urato. Urato and McFillin have both gone on the podcast hosted by Allie Beth Stuckey, a very popular right-wing influencer, to talk about the dangers of SSRIs. Joe Rogan has promoted several of the panelists.
What makes these communicators effective in the MAHA media space is not just their message, but how they go about delivering it. In the MAHA world, what matters more than studies and data is what feels right, especially if you don’t have a medical degree. It’s an accessible form of argumentation for the public, and one that encourages people to think about their own health with common sense and instinct.
When McFillin introduced himself at Monday’s FDA panel, he announced that the “public does not want to look at graphs or meaningless statistics” and said he would instead “speak from the heart.” Urato appealed to “common sense” when discussing the dangers of SSRIs, telling people to just “think about it”: “Chemicals have consequences.”
The simplicity of the message is appealing. As is the framing of their arguments as big, bold ideas that upend everything you know. If depression isn’t really a problem, if mental health isn’t a medical issue, if the entire way scientists claim to understand chemicals in the brain is all wrong, then maybe you should step away from the system entirely.
There’s a darker element of their argument, as well. In the panel, several speakers made the reality out to be quite frightening. “Never before in human history have we chemically altered babies like this,” Urato said at one point. Several emphasized that information was being kept from patients, who deserved full understanding of the risks of SSRIs in order to make informed decisions.
But if there was one underlying message of the FDA panel, it was not about SSRIs but about the system more broadly. It wasn’t just that this particular medical scenario needed more research; it was that the entire medical system was held captive by a villainous pharmaceutical industry, which actually sponsored the studies into SSRIs and pregnancy. No medical institutions could be trusted. It all came down to profit-making moves and advertising.
“The social reputation of these drugs as normalizing agents, akin to giving vitamin C in a case of scurvy, basically, is essentially a promotional message that our entire society has adopted,” the panelist Jeffrey Lacasse, an associate professor at Florida State University’s College of Social Work, said at one point.
These were, in other words, classic MAHA doctors, using classic MAHA lines of reasoning. It’s not clear how the FDA selected these particular figures to be on their panel, but it’s unlikely there was anything unexpected in what they said, given that the panelists had all spoken so publicly of their unorthodox views in other media. The FDA invited them onto a stage where, the moderators said, they hoped they would feel “uninhibited” to “challenge or defend current dogma.”
But there was one telling piece of context that showed just the real thinking behind the panel. As doctors who support SSRIs have said, the drugs do need more research in controlled studies with pregnant women. So far, partly because of ethical issues, but also partly because pregnant women are not often prioritized in medical research, there have been no randomized controlled trials of SSRIs in pregnant women. The American College of Obstetricians and Gynecologists has called for these to be done. As did the one pro-SSRI member of the FDA panel. According to the ACOG statement, the FDA had planned a working group on research on SSRIs in pregnancy, but because of the Trump administration’s cuts to the National Institutes of Health, that work has stalled. In a scenario in which the government sought better data on this medical question, the administration cut off the funding—and sent conspiracy theorists to talk about it instead.
