Hosts: Dr. Paul Marik, Dr. Joseph Varon Guest: Dr. Josef Witt-Doerring
Millions of people are prescribed SSRIs, but few are ever told what it takes to stop. In this eye-opening conversation, IMA Co-Founders Dr. Paul Marik and Dr. Joseph Varon sit down with psychiatrist and tapering expert Dr. Josef Witt-Doerring to expose the truth about antidepressants, dependency, and how patients can take back control of their mental health.
Founder of The Taper Clinic and a leading voice in psychiatric withdrawal care, Dr. Witt-Doerring shares the most surprising things he’s learned working with real patients—what happens when people try to quit, why so many suffer in silence, and how mainstream psychiatry has failed to prepare anyone for long-term outcomes.
In loving memory of our friend Charlie Kirk. May he rest in peace.
“SSRIs may have a role. But they shouldn’t be first-line therapy.” — Dr. Paul Marik
SSRIs are one of the most prescribed drug classes in the world, yet few patients are ever told what it takes to stop. Withdrawal is rarely discussed. Long-term use is often assumed. And the story most people are told—that depression is caused by a chemical imbalance and SSRIs fix it—doesn’t match what the science shows.
In this conversation, IMA Co-Founders Dr. Paul Marik and Dr. Joseph Varon speak with Dr. Josef Witt-Doerring, a psychiatrist and former FDA medical officer who now runs one of the few clinics focused exclusively on safe tapering. Together, they walk through what the profession gets wrong, what patients are rarely told, and what needs to change in how we think about depression, treatment, and recovery.
Introducing Dr. Josef Witt-Doerring
Dr. Josef Witt-Doerring, MD, is a psychiatrist renowned for his expertise in the field of drug tapering and withdrawal management. With years of experience in clinical psychiatry, he has developed a particular interest and specialization in assisting patients with the safe and effective tapering of psychiatric medications. His approach is patient-centered, focusing on individualized plans that prioritize the patient’s well-being and functioning.
- YouTube: @taperclinic
- Website: Taper Clinic
- Free Taper Training
“We are robbing people of the opportunity of addressing these issues at the root cause.” — Dr. Josef Witt-Doerring
The Chemical Myth and the Real Nature of Depression
Despite decades of public messaging, many people will be surprised to learn that there actually is no biological marker for depression and no scientific evidence that it stems from a serotonin imbalance. Dr. Witt-Doerring described that many experiments have been done comparing the serotonin levels in depressed and the general individuals; and in all of these experiments, there is a stunning throughline:
“Every time they’ve done this, they have not found that there is any difference between depressed and non-depressed people.” — Dr. Witt-Doerring
As Dr. Marik said, “That’s not a white lie then. That’s like a massive whopper.”
Instead of being caused directly by a chemical imbalance, Dr. Witt-Doerring emphasizes that depression is often a deeply human response to relationship strain, isolation, lack of purpose, or chronic stress.
“Depression is the logical cause of relationship breakdowns, social isolation, lack of purpose and meaning in one’s life, medical problems, particularly dietary issues, and also drug use. When you look peoples’ problems in that way, that really encapsulates a lot of what we call ‘depression’ and anxiety as well.” — Dr. Witt-Doerring
Short-Term Trials, Lifelong Use: The Problem With Default Prescribing
Since the COVID era, much more attention has been paid to drug safety. SSRIs are just another example of drugs that were not observed long enough to understand the true long term impacts. SSRIs were studied in clinical trials that lasted just 8 to 12 weeks. Yet many patients remain on them for years, even decades, without long-term safety data.
“They were tested for up to 12 weeks, but there are patients… who are on these drugs for decades. And that’s not what they were meant to be.” — Dr. Varon
Patients often cycle through multiple medications as tolerance builds, while the original causes of distress remain unaddressed.
“Eventually… you’re maxed out on the drug, and you go back and see the doctor and they say, ‘You’re treatment-resistant now.’” — Dr. Witt-Doerring
The prescribing pipeline is driven more by time constraints than personalized care.
“80% of the prescriptions are coming from… the family medicine doctor who is tasked with looking after your cardiovascular health, annual depression and anxiety — with like 5 to 10 minutes… Our healthcare system is really not designed to help people with anxiety and depression.” — Dr. Witt-Doerring
The Reality of Withdrawal
Many patients are never warned about withdrawal or how difficult it can be to stop. For some, a standard two-month taper leads to debilitating symptoms that persist for years. Though SSRIs are not chemically addictive in the traditional sense, withdrawal can be severe—and even the very best doctors may not be aware.
“Somebody started me on duloxetine. And oh, they forgot to tell me, Don’t you dare to stop this medication suddenly because you’re going to feel like hell.” — Dr. Varon
For some patients, withdrawal symptoms begin after just a few missed doses. And for many, they mimic or exceed the severity of the original depression—making it difficult to distinguish relapse from drug discontinuation.
“They get back on the drug expecting the symptoms to go away and they don’t. And it is extremely frightening.” — Dr. Witt-Doerring
Patients can get hit by a series of symptoms, as Dr. Witt-Doerring explains:
“They have ear ringing. They have light sensitivity. They have severe anxiety. They have brain fog. They develop digestion problems. They get tingling in their hands and feet. And it can drive people to suicide.”
Proper tapering can take months—or years. But most patients are given little to no guidance.
“In general, for people who are sensitive to withdrawal… they’re coming off between 12 months and 24 months.” — Dr. Witt-Doerring
Lasting Damage After the Drug
One of the most underreported concerns around SSRIs is the persistence of side effects even after discontinuation. Post-SSRI sexual dysfunction (PSSD), for example, has now been acknowledged in multiple countries’ drug labels.
“Up to 70% of people will have sexual dysfunction on these drugs… and for a growing number of people, they find it does not resolve.” — Dr. Witt-Doerring
Other long-term issues—such as increased impulsivity, mania, or aggression—are also acknowledged risks, yet rarely discussed during the prescribing process.
“These drugs can make people unexpectedly suicidal. They can make people violent and hostile. They can cause mania. They can cause a condition called Akathisia where you are very restless and uncomfortable and can sometimes do very unpredictable things.” — Dr. Witt-Doerring
Dr. Witt-Doerring explained at length that the connection from SSRI use to unpredictable violence is not debatable, but rather a clear causal link.
Learn more: Antidepressants and Violence: Problems at the Interface of Medicine and Law
A Different Way Forward
Rather than doubling down on a flawed model, Witt-Doerring argues for a more honest, patient-centered approach: acknowledge the limitations of the current drugs, support those who want to taper, and prioritize upstream factors, like sleep, purpose, connection, nutrition, and trauma healing.
It’s an approach echoed in Managing Depression, a monograph by Dr. Paul Marik, which outlines practical steps patients can take to reclaim agency and improve mental health. Like this conversation, the monograph challenges the idea that medication is the only—or even the best—tool. It’s not an anti-drug message. It’s a pro-truth, pro-recovery message.
Related Resources
More on: Depression | Dr. Josef Witt-Doerring | Dr. Joseph Varon | Dr. Paul Marik | mental health | SSRIs
