Antidepressant tapering by clinicians who understand

Outro provides comprehensive, affordable services for hyperbolic medication tapering, developed by patient advocates and world-leading experts in deprescribing.

Developed by patients & clinicians from leading institutions

Evidence-Based Deprescribing

A science-based method for safely stopping antidepressants

Grounded in the research and personal experience of our co-founder Dr. Mark Horowitz, Outro is the first virtual care solution dedicated to providing safe, evidence-based methods for people looking to stop antidepressants.

"I was on antidepressants for 15 years and, when I tried to come off them, 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

Co-Founder

Dr. Mark Horowitz | Outro Health | Antidepressant Tapering

Hyperbolic tapering plans

A neurobiology-based taper method that we personalize to each patient, based on factors like medication type and duration of use.

Visits with specialized clinicians

With regular video visits and asynchronous messaging, clinicians trained in deprescribing support you through every step of your tapering plan.

Custom medication sizes

Access to compounded prescriptions through our expert clinicians, to ensure your doses match your taper plan.

Non-drug mental wellness

Content, education and support in developing sustainable non-drug techniques like mindfulness, nutrition, movement and sleep.

Getting started on your journey

1

Meet your clinician

Answer a brief series of questions and get paired with a licensed Outro clinician, who will review your information to see if our tapering program is right for you.

2

Build your taper plan

If eligible, work with your Outro clinician to build a tapering plan that's personalized to you. We take into account your medication, medical history and life situation.

3

Be supported on your journey

Join Outro's taper management program to receive ongoing support to adjust your doses, monitor withdrawal symptoms, and feel supported along the way.

Who We Are

Meet some of our deprescribing experts

Dr. Mark Horowitz | Expert in antidepressant tapering and withdrawal
Mark Horowitz, MD
Co-Founder

Dr. Horowitz is the world-leading expert in deprescribing. Drawing from his personal experience and academic research, his work has informed international guidelines on safely stopping psychiatric medications.

Charlotte Herring NP | Outro Health
Charlotte Herring
Lead Nurse Practitioner

Charlotte is a nurse practitioner, health coach and mindfulness facilitator, highly experienced in providing high-quality care via telemedicine. She is passionate about helping patients build holistic  strategies for sustainable mental well-being.

Dr. Bryan Shapiro | Outro Health
Bryan Shapiro, MD
Medical Director

Dr. Shapiro is a board-certified psychiatrist, holding an academic position at UC Irvine Medical Center. He was involved in the conceptualization on hyperbolic tapering, driven by his own lived experience with antidepressant withdrawal.

Adele Framer | Outro Health
Adele Framer
Peer Support Advisor

Adele is a patient advocate and lay expert in tapering and withdrawal, having founded the website Surviving Antidepressants, as well as the Psychotropic Deprescribing Council, a nonprofit organization for research and education.

Who We Are

Meet some of our experts in deprescribing

Dr. Mark Horowitz | Expert in antidepressant tapering and withdrawal

Dr. Mark Horowitz

Dr. Horowitz is the world-leading expert in deprescribing. Drawing from his personal experience and academic research, his work has informed international guidelines on safely stopping psychiatric medications.

Dr. Mark Horowitz | Expert in antidepressant tapering and withdrawal

Charlotte Herring, NP

Charlotte is a nurse practitioner, health coach and mindfulness facilitator, highly experienced in providing high-quality care via telemedicine. She is passionate about helping patients build holistic strategies for sustainable mental well-being.

Dr. Mark Horowitz | Expert in antidepressant tapering and withdrawal

Dr. Bryan Shapiro

Dr. Shapiro is a board-certified psychiatrist, holding an academic position at UC Irvine Medical Center. He was involved in the conceptualization on hyperbolic tapering, driven by his own lived experience with antidepressant withdrawal.

Dr. Mark Horowitz | Expert in antidepressant tapering and withdrawal

Adele Framer

Adele is a patient advocate and lay expert in tapering and withdrawal, having founded the website Surviving Antidepressants, as well as the Psychotropic Deprescribing Council, a nonprofit organization for research and education.

We’re here to provide a safe, science-based option for stopping medications

Outro is building the first tech-enabled, comprehensive service for helping millions of people safely discontinue their psychiatric medications. This includes not only providing tapering services, but also developing research and awareness around withdrawal, safe tapering, and the promise of more sustainable approached to mental well-being.

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

Explore Outro's antidepressant tapering progam