RFK Jr. has targeted antidepressants for kids. How do SSRIs work?
In the first directive since his nomination to secretary of health and human services, Robert F. Kennedy Jr. thrust psychiatric medications and their use among children into the national spotlight.
The Trump administration introduced the initiative "Make our Children Healthy Again Assessment" in a February executive order that aims, in part, to "assess the prevalence of and threat posed by the prescription of selective serotonin reuptake inhibitors, antipsychotics, mood stabilizers, stimulants, and weight-loss drugs" within 100 days.
Kennedy, who is not a physician and has no medical or public health training, has said that the class of drugs known as selective serotonin reuptake inhibitors, or SSRIs, are harder to give up than heroin, and that school shootings became prevalent only after the introduction of Prozac, a common SSRI drug. These statements are riddled with falsehoods, according to health organizations, psychiatrists and researchers.
Related: Wisconsin health community expresses mix of curiosity and concern over RFK Jr. nomination
Related: Does Wisconsin have fluoride in its water, and is it good or bad for you? 6 things to know
Dr. Marcia Slattery, a physician and professor of psychiatry and pediatrics at the University of Wisconsin-Madison, focuses on anxiety disorders in patients between 5 and 18 years old. She could not speak to any of Kennedy's claims, but offered her expertise on SSRIs and their role in children's mental health.
Here's what to know.
Serotonin is a neurotransmitter in our brains associated with mood and emotions, sleep, appetite and digestion, learning and memory, pain perception and even bone health. Neurotransmitters carry messages between nerve cells in the brain, called neurons.
Typically, once a signal is passed between neurons, serotonin is reabsorbed in those cells, a process called "reuptake." SSRIs block this process of reuptake, which increases serotonin levels in your brain. That enables the brain to continue using serotonin to connect more dots as we go about everyday tasks.
Emotions also factor into how we think, problem solve and pay attention, Slattery said, and can affect the brain in ways that go beyond lifting some of the fog of depression and anxiety.
"Taking the medication basically is allowing the brain to operate in a healthy manner, in a normalized manner, that allows the kid to then engage," Slattery said.
Prescribing medications is never the first step in treating children and adolescents, Slattery said.
The psychiatrist or pediatrician works to better understand the bigger picture of a child's circumstances before taking out their prescription pad. A child's school environment may trigger anxiety, learning problems and bullying. Family dynamics can also play a role.
That said, medication helps to normalize the brain of a child experiencing severe anxiety and depression, Slattery said, which can allow a child to move forward and function more effectively, whether at home, at school or in social settings.
"When we do use medication, it still should be in conjunction with all these other non-pharmacological interventions," Slattery said. "That link gets lost a lot. People think all we're doing is prescribing medications as soon as a kid comes in and says they're anxious or they're depressed. That's not the case by a long stretch."
SSRIs can be life-saving medications, Slattery said.
Just as a pediatrician wouldn't ignore a child's severe asthma attacks, a psychiatrist or pediatrician isn't going to ignore signs of severe depression and anxiety, which are associated with higher risks of suicide and substance abuse, academic declines, decreased school performance, and "a lot of peer-social interaction problems," Slattery said.
During the pandemic, alarms rang out from different pediatric health groups about the youth mental health crisis. COVID exacerbated the burgeoning crisis among children and adolescents.
Between January 2016 and December 2022, the monthly antidepressant dispensing rate increased by 66%, according to a 2024 study from the American Academy of Pediatrics. At the same time, however, the decision to prescribe SSRIs for children and adolescents for depression and/or anxiety was largely found to be appropriate, another study published in the American Academy of Pediatrics concluded.
The use of SSRIs aligns with a grimmer fact: teenagers say they're more anxious, depressed and suicidal than they were prior to the pandemic. In Wisconsin, more than half of high schoolers reported having anxiety, 35% reported depression, 21% said they've intentionally harmed themselves, and 19% have considered suicide, according to the 2023 Youth Risk Behavior Survey.
Related: 'An urgent and difficult message': 59% of Wisconsin youth feel anxious, depressed or suicidal
Related: Youths in both urban and rural Wisconsin report troubling levels of food insecurity, poor mental health
Taking an SSRI doesn't have an immediate effect on the brain. It's a gradual change in the brain that targets a specific neurotransmitter, Slattery said.
"Literature would show that these are not addictive medications, and you're not on them for life," Slattery said.
Opiates like heroin activate the brain's reward system, releasing the chemical dopamine, a hallmark of addiction that inspires feelings of euphoria and bliss.
SSRIs, by and large, only target serotonin and have little effect on dopamine.
Comparing serotonin receptor sites with opiate receptor sites "is night and day," according to Sean Leonard, a psychiatric nurse practitioner from San Diego who focuses on addiction medicine told USA Today.
As with many medications, abrupt cessation can lead to symptoms of withdrawal according to the Canadian Medical Association Journal and are typically mild, producing flu-like symptoms, nausea and imbalance, among others.
After months of stable functioning in a patient, Slattery said she starts tapering down the dosage. In cases where anxiety crops up during that time, Slattery helps her patient use the skillsets developed in therapy to manage and cope with stress.
Slattery said it's better to reframe this question. Has severe depression or anxiety changed who you know your child to be?
SSRIs will change a child like any medication would. But Slattery described the change more as a release.
"It's like being unwrapped from cellophane. Your child is now able to experience the world and feel good about him or herself, and engage in life," Slattery said. "And so you will notice a difference in your child, but in a healthy way."
No.
Studies have yielded no causation between school shootings and psychotropic medications like SSRIs. A majority of school shooters had no history of taking these medications.
On the other hand, people with untreated serious mental illness are more likely to be victims of violence or self-inflict harm than be violent toward others.
Executive Order, Establishing the President's Make America Healthy Again Commission, Feb. 13, 2025
Jeffrey Kirchner, Is Robert F. Kennedy Jr. qualified to lead Health and Human Services?, Nov. 24, 2024
USA Today, RFK Jr.'s misinformation on antidepressants matters. Here's what to know, Jan. 30, 2025
Mayo Clinic, Selective serotonin reuptake inhibitors (SSRIs), Sep. 11, 2024
Zoom interview, Dr. Marcia Slattery with University of Wisconsin-Madison, Feb. 28, 2025
American Academy of Pediatrics, AAP-AACAP-CHA Declaration of a National Emergency in Child and Adolescent Mental Health, Oct. 19, 2021
American Academy of Pediatrics, Antidepressant Dispensing to US Adolescents and Young Adults: 2016–2022, Feb. 26, 2024
American Academy of Pediatrics, Anxiety and Depression Treatment in Primary Care Pediatrics, April 17, 2023
Wisconsin Department of Public Instruction, Wisconsin Youth Risk Behavior Survey Summary Report 2023, July 31, 2024
StatPearls, Selective Serotonin Reuptake Inhibitors, May 1, 2023
Canadian Medical Association Journal, Antidepressant discontinuation syndrome, May 29, 2017
Behavior Science Law, The myth of school shooters and psychotropic medications, Sep. 12, 2019
Psychiatric Services, Risks for individuals with schizophrenia who are living in the community, October 2001
This article originally appeared on Milwaukee Journal Sentinel: What to do know about SSRI antidepressants for kids, targeted by RFK
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RFK Jr. has promoted 'freedom of choice' while limiting vaccines, food
Prior to becoming Health and Human Services Secretary, Robert F. Kennedy Jr. had espoused the idea of "medical freedom," the ability of people to make personal health decisions for themselves and their families without corporate or government coercion. It's an idea supported under Kennedy's Make America Healthy Again (MAHA) movement to reduce the prevalence of chronic disease in the U.S. by making healthier lifestyle choices. On topics, such as vaccines, Kennedy has said he wouldn't prevent children from being able to receive vaccines but would leave the choice up to parents. MORE: CDC official who oversaw COVID vaccine recommendations resigns "I'm a freedom-of-choice person," Kennedy told Fox News host Sean Hannity during an interview in March. "We should have transparency. We should have informed choice, and if people don't want it, the government shouldn't force them to do it." Some public health experts told ABC News, however, that the HHS has been limiting choices on some products for many Americans despite Kennedy's talk about "freedom of choice." Just last week, Kennedy announced the Centers for Disease Control and Prevention would no longer recommend the COVID-19 vaccine for certain groups. Additionally, Kennedy has called on states to ban recipients of food stamps from being able to use them to purchase soda. He has also praised states for banning fluoride from public drinking water and indicated he will change federal guidance on recommending adding fluoride. The public health experts said Kennedy's actions are setting up a dichotomy on public health. "I think that RFK Jr. has done a really good job of identifying some of the problems [in public health], but it's the solutions that are problematic," Dr. Craig Spencer, an associate professor of the practice of health services, policy and practice at Brown University School of Public Health, told ABC News. "What you're seeing with RFK Jr. and his approach to health is an individualization of public health. It's this idea that you can make decisions for your health, and that's always been true." He went on, "We need to be able to follow their guidance, not just have them tell us, 'Follow your own science.' As the focus shifts from community to individuals, we're losing a lot of that underpinning, which has led to a lot of the gains in public health." Kennedy has repeatedly stated that he is not anti-vaccine and that he supports vaccination. Shortly after Trump's election, Kennedy said in an interview with NBC News that "if vaccines are working for somebody, I'm not going to take them away. People ought to have choice, and that choice ought to be informed by the best information." MORE: CDC official who oversaw COVID vaccine recommendations resigns During his confirmation hearings, Kennedy said he supported the childhood vaccination schedule and that he would not do anything as head of HHS that "makes it difficult or discourages people from taking vaccines." Separately, in an opinion piece Kennedy wrote for Fox News in March on the nationwide measles outbreak, he said the measles vaccine helps protect individuals and provides "community immunity" but also called the decision to vaccinate a "personal one." However, last week, Kennedy announced the removal of the COVID-19 vaccine from the CDC's immunization schedule for "healthy children and healthy pregnant women." The CDC's immunization schedule is not just a guide for doctors but also determines insurance coverage for most major private plans and Medicaid expansion programs. Following Kennedy's announcement, the schedule was updated noting all children would be eligible for COVID vaccines, but now under a shared-clinical decision-making model -- allowing parents to choose whether their children are vaccinated alongside advice from a doctor. "Regarding the vaccines, HHS is restoring the doctor-patient relationship," HHS spokesperson Andrew Nixon told ABC News in a statement. "We are encouraging those groups to consult with their health care provider to help them make an informed decision. This is freedom of choice." "If you restrict access, you necessarily restrict choice," Dr. Matthew Ferrari, a professor of biology and director of the Center for Infectious Disease Dynamics at Pennsylvania State University, told ABC News. "Those two things are antithetical. You can't do both. You can't say you're allowing choice if you're restricting access." Ferrari said the idea of "medical freedom" is catchy, but public health recommendations are made based on how to protect the most vulnerable individuals. "If you look at the outcomes, if you look at the consequences of that movement, it has been to disproportionately restrict access to -- and restrict support and infrastructure to allow people to access -- preventive medicine," he said. "It's sort of easy to say, 'Well, take the vaccine away. But [vaccines] prevent a future outcome of illness for yourself and for others in the community." Traditionally, the CDC's Advisory Committee for Immunization Practices decides if there is a benefit to a yearly vaccine and who should get it. The independent advisory committee then makes recommendations to the CDC, which has the final say. The committee was set to meet in late June to vote on potential changes to COVID vaccine recommendations. Spencer said Kennedy's bypassing of traditional avenues when it comes to changing vaccine recommendations is also taking away choice from people. "This did not go through the normal process that it should have, and he basically just made a decision for people while at the same time saying that he's going to let people make a decision," Spencer said. Kennedy has also campaigned to prevent Americans from using food stamps -- provided under the Supplemental Nutrition Assistance Program -- to buy candy and soda. "It's nonsensical for U.S. taxpayers to spend tens of billions of dollars subsidizing junk that harms the health of low-income Americans," Kennedy wrote in an opinion piece for The Wall Street Journal last September. MORE: RFK Jr. to tell medical schools to teach nutrition or lose federal funding At a MAHA event in late May, Kennedy said the governors of 10 states have submitted waivers to the United States Department of Agriculture requesting permission to ban SNAP recipients from using benefits to buy candy and soft drinks. "The U.S. government spends over $4 trillion a year on health care," Nixon said in a statement. "That's not freedom -- it's failure. Secretary Kennedy is unapologetically taking action to reverse the chronic disease epidemic, not subsidize it with taxpayer dollars. Warning Americans about the dangers of ultra-processed food isn't an attack on choice -- it's the first step in restoring it." Nutrition experts agree that sugar-sweetened beverages (SSBs) are unhealthy. Frequent consumption of SSBs is linked to health issues such as weight gain, obesity, type 2 diabetes, tooth decay, heart disease and kidney diseases, according to the CDC. Kristina Petersen, an associate professor in the department of nutritional sciences at Pennsylvania State University, told ABC News there is a crisis of diet-related diseases in the U.S., which increase the risk of disability and reduces lifespan. However, she said there needs to be strong evidence of the benefits of restrictive policies if they are to be put in place. "In terms of limiting people's choices, it is important to consider all the different roles that food plays in someone's life, and so obviously we want people eating nutritious foods, but also we need to acknowledge that food is a source of enjoyment," Petersen said. "A lot of social situations revolve around food. So, when we're thinking about reducing people's access to given foods, we need to think about the consequences of that." One unintended consequence could be an eligible family not signing up for SNAP benefits because of the restrictions, she said. Even if a ban on buying candy and soda with SNAP benefits does occur, Petersen said she is not aware of any evidence that shows banning certain foods leads to healthier diets. She added that the nation's dietary guidelines are written to emphasize healthy foods like fruits and vegetable rather than telling people to avoid or restrict less healthy foods. "All foods can be consumed as part of a healthy dietary pattern. It's really just the amount and the frequency that determines whether that pattern is helpful overall or less helpful," Petersen said. "People can have small indulgences, but really, we're interested in what is their pattern over a period of time." Providing incentives for purchasing healthier foods may be more effective and still allow people to have choice, Petersen said. A 2018 study used a model simulation to study the effects of food incentives, disincentives or restrictions in SNAP. One of the simulations involving incentives for foods such as fruits, vegetables, nuts, whole grains, fish and plant-based oils found to have the most substantial health benefits and be the most cost-effective. "Things like fruits and vegetables, they do tend to be more expensive, so if you incentivize them by providing more benefits … that's making the dollar go further, and it's kind of making the economic piece of this a bit stronger," Petersen said. "A lot of this is framed around personal choice. Rather than restricting access to, how can we give people more access to healthy foods? I think that's going to have the greatest benefit here." ABC News' Youri Benadjaoud and Cheyenne Haslett contributed to this report. RFK Jr. has promoted 'freedom of choice' while limiting vaccines, food originally appeared on
2 hours ago
RFK Jr. has promoted 'freedom of choice' while limiting vaccines, food
Prior to becoming Health and Human Services Secretary, Robert F. Kennedy Jr. had espoused the idea of "medical freedom," the ability of people to make personal health decisions for themselves and their families without corporate or government coercion. It's an idea supported under Kennedy's Make America Healthy Again (MAHA) movement to reduce the prevalence of chronic disease in the U.S. by making healthier lifestyle choices. On topics, such as vaccines, Kennedy has said he wouldn't prevent children from being able to receive vaccines but would leave the choice up to parents. "I'm a freedom-of-choice person," Kennedy told Fox News host Sean Hannity during an interview in March. "We should have transparency. We should have informed choice, and if people don't want it, the government shouldn't force them to do it." Some public health experts told ABC News, however, that the HHS has been limiting choices on some products for many Americans despite Kennedy's talk about "freedom of choice." Just last week, Kennedy announced the Centers for Disease Control and Prevention would no longer recommend the COVID-19 vaccine for certain groups. Additionally, Kennedy has called on states to ban recipients of food stamps from being able to use them to purchase soda. He has also praised states for banning fluoride from public drinking water and indicated he will change federal guidance on recommending adding fluoride. The public health experts said Kennedy's actions are setting up a dichotomy on public health. "I think that RFK Jr. has done a really good job of identifying some of the problems [in public health], but it's the solutions that are problematic," Dr. Craig Spencer, an associate professor of the practice of health services, policy and practice at Brown University School of Public Health, told ABC News. "What you're seeing with RFK Jr. and his approach to health is an individualization of public health. It's this idea that you can make decisions for your health, and that's always been true." He went on, "We need to be able to follow their guidance, not just have them tell us, 'Follow your own science.' As the focus shifts from community to individuals, we're losing a lot of that underpinning, which has led to a lot of the gains in public health." Limiting access to COVID-19 vaccines Kennedy has repeatedly stated that he is not anti-vaccine and that he supports vaccination. Shortly after Trump's election, Kennedy said in an interview with NBC News that "if vaccines are working for somebody, I'm not going to take them away. People ought to have choice, and that choice ought to be informed by the best information." During his confirmation hearings, Kennedy said he supported the childhood vaccination schedule and that he would not do anything as head of HHS that "makes it difficult or discourages people from taking vaccines." Separately, in an opinion piece Kennedy wrote for Fox News in March on the nationwide measles outbreak, he said the measles vaccine helps protect individuals and provides "community immunity" but also called the decision to vaccinate a "personal one." However, last week, Kennedy announced the removal of the COVID-19 vaccine from the CDC's immunization schedule for "healthy children and healthy pregnant women." The CDC's immunization schedule is not just a guide for doctors but also determines insurance coverage for most major private plans and Medicaid expansion programs. Following Kennedy's announcement, the schedule was updated noting all children would be eligible for COVID vaccines, but now under a shared-clinical decision-making model -- allowing parents to choose whether their children are vaccinated alongside advice from a doctor. "Regarding the vaccines, HHS is restoring the doctor-patient relationship," HHS spokesperson Andrew Nixon told ABC News in a statement. "We are encouraging those groups to consult with their health care provider to help them make an informed decision. This is freedom of choice." "If you restrict access, you necessarily restrict choice," Dr. Matthew Ferrari, a professor of biology and director of the Center for Infectious Disease Dynamics at Pennsylvania State University, told ABC News. "Those two things are antithetical. You can't do both. You can't say you're allowing choice if you're restricting access." Ferrari said the idea of "medical freedom" is catchy, but public health recommendations are made based on how to protect the most vulnerable individuals. "If you look at the outcomes, if you look at the consequences of that movement, it has been to disproportionately restrict access to -- and restrict support and infrastructure to allow people to access -- preventive medicine," he said. "It's sort of easy to say, 'Well, take the vaccine away. But [vaccines] prevent a future outcome of illness for yourself and for others in the community." Traditionally, the CDC's Advisory Committee for Immunization Practices decides if there is a benefit to a yearly vaccine and who should get it. The independent advisory committee then makes recommendations to the CDC, which has the final say. The committee was set to meet in late June to vote on potential changes to COVID vaccine recommendations. Spencer said Kennedy's bypassing of traditional avenues when it comes to changing vaccine recommendations is also taking away choice from people. "This did not go through the normal process that it should have, and he basically just made a decision for people while at the same time saying that he's going to let people make a decision," Spencer said. Restricting foods under SNAP Kennedy has also campaigned to prevent Americans from using food stamps -- provided under the Supplemental Nutrition Assistance Program -- to buy candy and soda. "It's nonsensical for U.S. taxpayers to spend tens of billions of dollars subsidizing junk that harms the health of low-income Americans," Kennedy wrote in an opinion piece for The Wall Street Journal last September. At a MAHA event in late May, Kennedy said the governors of 10 states have submitted waivers to the United States Department of Agriculture requesting permission to ban SNAP recipients from using benefits to buy candy and soft drinks. "The U.S. government spends over $4 trillion a year on health care," Nixon said in a statement. "That's not freedom -- it's failure. Secretary Kennedy is unapologetically taking action to reverse the chronic disease epidemic, not subsidize it with taxpayer dollars. Warning Americans about the dangers of ultra-processed food isn't an attack on choice -- it's the first step in restoring it." Nutrition experts agree that sugar-sweetened beverages (SSBs) are unhealthy. Frequent consumption of SSBs is linked to health issues such as weight gain, obesity, type 2 diabetes, tooth decay, heart disease and kidney diseases, according to the CDC. Kristina Petersen, an associate professor in the department of nutritional sciences at Pennsylvania State University, told ABC News there is a crisis of diet-related diseases in the U.S., which increase the risk of disability and reduces lifespan. However, she said there needs to be strong evidence of the benefits of restrictive policies if they are to be put in place. "In terms of limiting people's choices, it is important to consider all the different roles that food plays in someone's life, and so obviously we want people eating nutritious foods, but also we need to acknowledge that food is a source of enjoyment," Petersen said. "A lot of social situations revolve around food. So, when we're thinking about reducing people's access to given foods, we need to think about the consequences of that." One unintended consequence could be an eligible family not signing up for SNAP benefits because of the restrictions, she said. Even if a ban on buying candy and soda with SNAP benefits does occur, Petersen said she is not aware of any evidence that shows banning certain foods leads to healthier diets. She added that the nation's dietary guidelines are written to emphasize healthy foods like fruits and vegetable rather than telling people to avoid or restrict less healthy foods. "All foods can be consumed as part of a healthy dietary pattern. It's really just the amount and the frequency that determines whether that pattern is helpful overall or less helpful," Petersen said. "People can have small indulgences, but really, we're interested in what is their pattern over a period of time." Providing incentives for purchasing healthier foods may be more effective and still allow people to have choice, Petersen said. A 2018 study used a model simulation to study the effects of food incentives, disincentives or restrictions in SNAP. One of the simulations involving incentives for foods such as fruits, vegetables, nuts, whole grains, fish and plant-based oils found to have the most substantial health benefits and be the most cost-effective. "Things like fruits and vegetables, they do tend to be more expensive, so if you incentivize them by providing more benefits … that's making the dollar go further, and it's kind of making the economic piece of this a bit stronger," Petersen said. "A lot of this is framed around personal choice. Rather than restricting access to, how can we give people more access to healthy foods? I think that's going to have the greatest benefit here."
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