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.

Outro is for people 18 years and older who are currently taking an antidepressant medication and thinking about decreasing or stopping the medication altogether. 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
• Have attempted to end their life in the past 12 months
• Are actively suicidal or in crisis

To see if you are a candidate for Outro’s services, click “Get Started”.

If you are in a life-threatening situation, call 911 or the National Suicide Prevention Line at +1-833-456-4566, or go to the nearest emergency room.

Going cold turkey (stopping in one day) is not a good idea! Why? Because the quicker you stop your antidepressant the more severe your withdrawal symptoms are likely to be, and the higher the likelihood that you’ll need to go back on your medication.

Sometimes these symptoms can be so unpleasant that they interfere with your ability to work or carry on normal social activities. Sometimes severe withdrawal symptoms can be very disruptive or even lead to hospitalization.

Tapering (stopping slowly in small steps) is therefore highly recommended to minimize the risks of these issues.

Hyperbolic tapering (sometimes called the Horowitz-Taylor method)¹ 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.

These very low doses are difficult to make up with commonly available tablets, so Outro recommends compounding pharmacies to make these options available.

1. Horowitz MA, Taylor D. Tapering of SSRI treatment to mitigate withdrawal symptoms. The Lancet Psychiatry. 2019;6(6):538-546.

You do not need a referral from your primary doctor or healthcare provider to work with Outro. However, with your permission we may reach out to your primary care provider for more information on your medical history, or to keep your primary doctor informed of your medical progress if you decide to subscribe to Outro.

Antidepressant discontinuation is a serious process that demands specialized knowledge and attention. Our methods minimize the main risks of stopping: disruptive withdrawal symptoms or relapse, which cause many people to go back on their medications.

Grounded in first-hand experience and the latest scientific evidence, Outro's care team provides the personalized guidance and support that members need to graduate from their time on antidepressants, and onto a path of sustainable mental well-being.