Antidepressants first emerged in the 1950s, when researchers discovered that certain drugs developed for other purposes—like tuberculosis and schizophrenia—had mood-elevating effects. This led to the development of tricyclic antidepressants (TCAs) and monoamine oxidase inhibitors (MAOIs), which became the first generation of medications used to treat low mood.

By the late 1980s, selective serotonin reuptake inhibitors (SSRIs) entered the market, with fluoxetine (Prozac) leading the way. These newer drugs were heavily promoted as safer, more targeted and more tolerable than their predecessors. Pharmaceutical companies leaned into this narrative, despite the lack of long-term safety data and growing anecdotal evidence of adverse effects, dependence, and withdrawal.

Prozac quickly became a cultural phenomenon. Its release coincided with a wave of optimistic media coverage that portrayed the drug not just as a treatment for depression, but as a way to enhance personality traits—boosting confidence, reducing social anxiety, and creating a more desirable version of oneself. This gave rise to public fascination and concern about the use of antidepressants to create so-called “designer personalities.” The idea that a pill could shape emotional and social identity raised ethical questions about authenticity, the medicalization of normal emotions, and the pressures to conform to societal ideals of happiness and productivity.

But as Prozac’s popularity soared, so did reports of troubling side effects. Throughout the 1990s, Eli Lilly, the drug’s manufacturer, faced hundreds of lawsuits alleging that Prozac had caused or contributed to suicidality, violent behavior, and psychological destabilization. One of the most notable cases was Fentress v. Shea Communications, in which families of victims of a 1989 mass shooting blamed Prozac for the shooter’s actions. Although the jury ruled in Eli Lilly’s favor, it was later revealed that a secret settlement had been made during the trial, raising serious questions about transparency. Internal company documents uncovered during litigation suggested that Eli Lilly was aware of suicide risks during clinical trials but had failed to adequately warn patients and prescribers. By the mid-1990s, the company had settled around 300 lawsuits. These cases, combined with mounting anecdotal reports, intensified public skepticism and regulatory scrutiny, ultimately forcing a broader conversation about the true risks of SSRIs and the ethics of pharmaceutical marketing.

In response to this growing scrutiny and the rising public awareness around the dependence potential of other substances like benzodiazepines, pharmaceutical companies took steps to protect the image of SSRIs. A key moment in this effort came in 1997, when the term “discontinuation syndrome” was coined by a panel convened by Eli Lilly, the manufacturer of Prozac (fluoxetine), to address the increasing reports of withdrawal symptoms following the cessation of SSRIs. The goal was to reframe the conversation around these symptoms, distancing them from the term “withdrawal,” which is commonly associated with substances considered dependence-forming, like opioids or benzodiazepines. However, this shift in terminology has been widely criticized. Many clinicians and researchers argue that discontinuation syndrome minimizes the reality and severity of SSRI withdrawal, which can be prolonged, debilitating, and clinically indistinguishable from withdrawal seen with other drugs. The term has contributed to ongoing confusion among prescribers and the public, further complicating proper recognition and support for those affected.

Prescribers, often relying on biased or incomplete information provided by pharmaceutical representatives and outdated clinical guidelines, remain largely uneducated on the risks of withdrawal, the need for slow tapering, or the full spectrum of adverse effects. Patients frequently report being dismissed, misdiagnosed, or rapidly tapered, further compounding the harm.

In response to this widespread lack of institutional support, grassroots advocacy efforts emerged. One of the most influential resources in this space is Surviving Antidepressants, a long-standing peer support forum that now hosts thousands of members navigating the complexities of antidepressant withdrawal. Founded by a person with lived experience, the site has become a cornerstone of the withdrawal support community. This community-led movement has become a lifeline for many and continues to expose the shortcomings of the mental health care system when it comes to informed consent and safe discontinuation.

Today, we are at a turning point. With rising awareness, patient advocacy, and calls for reform, it is critical to confront the uncomfortable truth: antidepressants can cause physical dependence, and the medical community must take responsibility for educating itself and the public on the real risks involved.