Antidepressants don’t have to be forever

Outro is the first service for safe, evidence-based antidepressant tapering, designed by expert clinicians and patients who’ve been there.

The first evidence-based approach to stopping medications

Based in Dr. Mark Horowitz's leading research, Outro's tapering program combines neurobiology-based tapering, integrative approaches and virtual care to provide an accessible, personalized path off medication.

Developed by patients, clinicians and researchers from leading institutions

"I was on antidepressants for 15 years and when I tried to come off them, at the end of my Ph.D., I struggled with severe withdrawal symptoms. It was the most awful experience of my life. I found there was a lack of support and knowledge from clinicians and researchers on how to safely stop antidepressants and manage withdrawal, which led me to co-found Outro."

Dr. Mark Horowitz

Scientific Co-Founder

Dr. Mark Horowitz | Expert in antidepressant tapering and withdrawal
Taper Program

A comprehensive program for safe tapering

Antidepressant tapering appointment | Outro

Science-based taper plans

A neurobiology-based method that's personalized to you, hyperbolic tapering helps minimize withdrawal symptoms and reduces the risk of relapse.

Outro Health's antidepressant tapering service

Support from expert clinicians

Trained by world-leading experts in deprescribing, Outro's clinical team is equipped to help build your taper plan and support you with regular visits.

Outro Health's antidepressant tapering service

Access to custom prescriptions

We work with compounding pharmacy partners that provide the custom dose sizes you need for safe, evidence-based tapering.

Hyperbolic Tapering

The first tapering method based on neurobiology

Despite the millions of people prescribed antidepressants, there have been no evidence-based approaches to getting off them.

Outro's method is the first approach based on science, accounting for the non-linear effect of dose changes on the brain, and putting the patient at the center of the tapering process.

How It works

Start building your personalized taper plan with Outro

Complete the onboarding

Answer a brief series of questions to see if you could be a fit for our virtual tapering program.

Attend your first visit

Meet with one of our clinicians who can assess your eligibility and build you a personalized taper plan.

Join our taper program

Become a member of Outro's tapering program and receive ongoing support on your path off medication.

FAQs

Explore commonly asked questions about Outro's services, medication withdrawal, tapering and more.

Who is Outro for?

Outro is for people 18 years and older who are currently taking an antidepressant medication and thinking about decreasing or stopping the medication altogether.

As a virtual care service, Outro’s services are currently not available for people in certain situations or with certain conditions. These include (but are not limited to) people who:

  • Have active and serious substance abuse issues
  • Have been diagnosed with dementia
  • Have been diagnosed with schizophrenia or schizoaffective disorder
  • Have been hospitalized for bipolar disorder in the past 12 months
  • Have attempted to end their life in the past 12 months
  • Are actively suicidal or in crisis
How is Outro different?

Safe antidepressant deprescribing requires a comprehensive approach that is often difficult for an individual prescriber to provide, due to the time required. It also requires up-to-date knowledge on the latest techniques in tapering antidepressants that are not yet widely taught in North America. Think of Outro as a specialist in tapering.

At Outro, we walk with you every step of the way. Our specialized, high-touch care team takes time to get to know you and your goals, and provides an advanced, individualized approach to tapering off antidepressants informed by the latest guidance and clinical evidence. Through Outro’s app, your symptoms and progress are continuously monitored by your Provider, who can reach out to offer coping strategies or adapt your care plan accordingly. If you have questions or concerns that arise in between appointments, your Outro provider is available via 1-to-1 chat.

What if I've tried to stop before?

Many people have difficulties when they try to go off antidepressants. Our team of expertly trained clinicians will develop a tailored tapering program, informed by the latest scientific evidence and designed to minimize withdrawal effects - even for these people who have tried to stop before.

What is hyperbolic tapering?

Hyperbolic tapering (sometimes called the Horowitz-Taylor method) is based on the fact that as antidepressant dose goes up, drug action on brain cells increases, but not in equal steps, higher dosages having less and less additional influence – a decreasing return on investment. The graph showing this is called a hyperbolic curve (goes up faster at low doses and flatter at higher doses).

Tapering based on this method gradually backs you out of the drug with reductions following this natural curve, with the size of dose reduction getting smaller as the dosage gets lower. As very low doses (e.g. 1 or 2mg) have much larger effects than people expect, many people need to taper down to very small doses before stopping so that the final ‘jump’ to zero is not too large a shock to the nervous system.

How do compounded medications work?

Compounded medications are often crucial in the tapering process, as commonly available dose sizes aren't small enough to reach the sizes necessary to follow a safe tapering plan. For example, the smallest usually available dose size for venlafaxine is 37.5mg (a drop from 37.5mg to 0mg can easily lead to debilitating withdrawal symptoms).

The costs of medications are not included in your Outro subscription. To help you in your taper, Outro works in partnership with leading compounding pharmacies to provide the most reliable and affordable medication formulations and sizes. Speak with your Outro provider to learn more!

What medications does Outro taper?

We currently offer taper management for antidepressant medications (e.g., duloxetine, escitalopram, sertraline, venlafaxine). You can see the full list here.

We are making preparations to expand to other psychotropic medications like benzodiazepines and gabapentinoids, which also follow the hyperbolic tapering method. You can express an interest in tapering these medications in our sign-up form.

Where is Outro available?

Outro is currently serving patients in California. If you are located in another US state, be sure to express your interest via our sign-up form. We'll be providing regular updates and announcements as we expand our reach.

Personalized tapering support that’s ready when you are