On a recent episode of The Joe Rogan Experience, Joe Rogan and guest Brigham Buhler made a series of claims while discussing how the FDA handles d**g label changes. The conversation began with Buhler breaking down what a “major label change” actually looks like in practice, using antidepressants as a key example.
“An example with antidepressants,” Buhler explained, “they realized the suic idal ideation in teenagers, right, and they had to change that label… and say, hey, not only is this only a fraction better than a placebo, right, barely differentiates from placebo retrospectively.”
Rogan quickly built on that point with a blunt comparison: “And not even close to exercise.”
Buhler didn’t push back. He said: “I know. It’s literally… exercise is six to sevenfold more efficacious than an antidepressant.”
“How wild is that?” Rogan agreed.
From there, Buhler shifted the discussion toward the scientific foundations behind antidepressants, particularly the long-standing serotonin theory.
“And then you go back to the science,” he said. “The science was all cooked books. It was all said that it was SRI serotonin-related, and there was never a single study that correlated depression to serotonin. It was all dogma created by industry.”
This exchange came within a conversation about how medical dogma can take hold and persist over decades. Earlier, Buhler had referenced figures from a book by Marty Makary, noting that an estimated 60 to 80 percent of d**gs that pass FDA approval eventually undergo major label changes or are recalled.
The antidepressant example, in this context, served as a case study: a widely adopted class of d**gs later updated with serious warnings and increasingly scrutinized for limited efficacy over placebo.
The serotonin hypothesis, in particular, has come under renewed examination in recent years. For decades, depression was commonly framed as a chemical imbalance linked to low serotonin levels. It was a narrative that helped drive the widespread use of selective serotonin reuptake inhibitors (SSRIs).
Previously, Joe Rogan had made a similar point about the role of physical activity in treating depression. He noted that exercise has been shown in some studies to be “one and a half times more effective than SSRIs,” reinforcing the idea that movement is central to mental health treatment.
He also shared a personal experience, explaining that while SSRIs helped stabilize their mood, the effects of exercise felt more immediate and tangible.
A similar skepticism toward antidepressants has been echoed by Bryan Johnson, who has been vocal about what he sees as their limited evidence base.
Speaking on a podcast appearance, Johnson argued that SSRIs are often prescribed more broadly than the data supports, raising concerns about overreliance on pharma solutions.
Instead, Johnson advocates for a “foundations-first” approach, emphasizing sleep, exercise, and nutrition as the most powerful tools for improving mental health. Beyond lifestyle changes, he pointed to emerging alternatives like Transcranial Magnetic Stimulation (TMS), particularly newer protocols showing high recovery rates in treatment-resistant cases.
