Unlike a linear taper, which involves reducing the dose of a medication by the same amount each time, a hyperbolic taper gradually slows the rate of reduction—cutting smaller and smaller amounts as it goes—so that the final doses are extremely small and spread out over a much longer period. To facilitate this, Outro partners with compounding pharmacies to produce custom versions of generic antidepressants in minuscule doses that are not available commercially. In other words, while Outro promotes itself as a service for getting off medication, part of its business model hinges on people continuing to take the compounded drugs its clinicians prescribe.

Horowitz, who has become one of the UK's leading experts on medication tapering, known as de-prescribing, says his interest in the topic was driven by his own harrowing experience coming off antidepressants more than a decade ago when he was a psychiatry doctoral student. Horowitz crafted a gradual tapering plan for himself that involved using syringes from his research lab to dole out small liquid doses of escitalopram, known by the brand name Lexapro. But he couldn’t prevent the misery induced by discontinuing the drug.

“My life exploded,” Horowitz says. His symptoms, which included severe insomnia and dizziness, were so debilitating that he moved back in with his parents. “It took me years to come off, not weeks as guidelines recommended.”

After he recovered, Horowitz began pushing for doctors to adopt new clinical guidelines for getting off antidepressants. He coauthored the Royal College of Psychiatry's guidance for psychiatric drug cessation and joined the UK’s National Health Service as a clinical research fellow. His goal with Outro is to bring the guided tapering methods he has developed to a new patient base in North America.

Goode, Outro’s CEO, has a background working in pharmaceuticals and telehealth that includes stints at Novo Nordisk and the psychedelic therapy startup Field Trip Health, now known as Stella. “People kept asking how to use psychedelics to get off antidepressants,” Goode says, which led him to suspect there might be a substantial swath of the population who wanted help quitting the drugs.

Horowitz and Goode cofounded Outro in 2022 along with another Field Trip alum, Tyler Dyck. The company’s small team also includes Adele Framer, the founder of Surviving Antidepressants, a long-running forum wh...