Before he became a critic of how psychiatric medication gets prescribed, this guest was inside the machine that builds it: a clinical development team at Johnson & Johnson's Janssen, then the FDA's division of psychiatry, reviewing the drugs that end up in nearly every American medicine cabinet. In this conversation, he explains why 15-minute appointments turned mental healthcare into a symptom checklist, how SSRIs like Prozac, Lexapro, and Zoloft work by blunting emotional range rather than addressing root cause, and the mismatch he says doctors rarely disclose: no antidepressant clinical trial has ever run longer than a year, while most patients stay on them for a median of two years, and some for decades.

He also gets into what he says he witnessed firsthand: patients whose medications stopped working over time, personality changes tied to long-term use, and cases where worsening symptoms were treated as a new diagnosis rather than a side effect of the drug itself. Six years ago, he and his wife, also a psychiatrist, left conventional practice to build a clinic focused on helping people safely come off psychiatric medication and learn the non-drug approaches to mental health he believes should have been offered from the start.

Topics covered:

• Why 15-minute appointments reshaped psychiatry around a symptom checklist
• How SSRIs actually work, and what "numbing" versus "root cause" really means
• The gap between how long these drugs are studied and how long people take them
• Personality and emotional changes tied to long-term antidepressant use
• Why he left a career at Janssen and the FDA to build a clinic focused on safe tapering