Uploaded August 2026 | Updated September 2026, 2 weeks ago

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⚠️ This episode discusses antidepressants, mental health treatment, withdrawal and sensitive topics around psychiatric medication. Please seek professional guidance before making any changes to your medication.

This week I'm joined by Dr Mark Horowitz, clinical research fellow in psychiatry and co-author of the Maudsley Prescribing Guidelines, and someone who has dedicated his career to changing the way we understand antidepressants and how to come off them safely.
We explore the science behind antidepressants, what they actually do to the brain, and what nobody told you about coming off them.

Dr Mark Horowitz is a clinical research fellow at University College London whose research has directly changed NHS and international prescribing guidelines on antidepressant withdrawal. He has personal experience of withdrawal himself, which is what led him to dedicate his career to helping others through the same process.

What we explore together:
•Why 1 in 6 people in England are on antidepressants and whether we are overprescribing
•What antidepressants actually do to the brain and why the chemical imbalance theory is misleading
•Why the clinical trial data on antidepressants is far less impressive than most people realise
•The emotional blunting effect, what it is, why it happens and what to do about it
•Why 85% of people recover from depression within 12 months with no intervention at all
•What withdrawal actually feels like and why doctors so often get it wrong
•How to taper safely and why doing it too fast causes so much unnecessary suffering
•What the alternatives to antidepressants are and why they are rarely offered first

Love, Sarah Ann 💛
Learn more about Dr Mark Horowitz and his work:
Dr Horowitz on X: https://x.com/markhoro
Dr Horowitz's website: markhorowitz.org
Outro Health's virtual tapering clinic (US): outro.com

My book 'Healthy Shouldn't Be This Hard': amazon.co.uk/Healthy-Shouldnt-Be-This-Hard-ebook/dp/B0G1DHNRV5

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Chapters
00:00 Introduction
02:44 Are we overprescribing antidepressants
06:08 How the psychiatric profession medicalised normal human emotions
09:07 The Defeat Depression campaign and who funded it
12:00 What antidepressants actually do in the brain
15:04 The clinical trial data, what it really shows
18:00 Why people say antidepressants saved their life
21:01 Emotional blunting, losing the full range of feeling
24:00 Who should and shouldn't consider antidepressants
27:02 The side effects nobody tells you about
30:05 Sexual dysfunction and antidepressants
33:00 The chemical imbalance theory, where it came from
36:02 Alternatives to antidepressants the NHS actually recommends
39:08 The 85% recovery statistic
42:00 What withdrawal actually feels like
45:07 Why doctors get withdrawal so wrong
48:00 Why coming off too fast causes so much suffering
51:08 How to taper safely
54:06 Why small doses matter more than people think
57:07 How long tapering can take
60:00 Mark's own experience of withdrawal
63:02 The Maudsley Prescribing Guidelines
66:04 What needs to change in psychiatry
69:08 The role of therapy alongside medication
72:00 Postnatal depression and antidepressants
75:02 PMDD and the evidence for medication
78:00 What to do if you want to come off your medication
81:07 Diet, lifestyle and mental health
84:04 Final thoughts on living well and being well