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Psychiatr Serv. 2016 Aug 1;67(8):904-7. doi: 10.1176/appi.ps.201500359. Epub 2016 Mar 15.

A Prescription for "Deprescribing" in Psychiatry.

Author information

1
The authors are with the Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, and with the Abraham Ribicoff Research Facilities, Connecticut Mental Health Center, New Haven (e-mail: swapnil.gupta@yale.edu ).

Abstract

The term "deprescribing," initially coined in geriatric medicine, describes a process of pharmacologic regimen optimization through reduction or cessation of medications for which benefits no longer outweigh risks. Burgeoning rates of polypharmacy, growing appreciation of long-term adverse effects, and a focus on patient-centered practice present specific indications for deprescribing in psychiatry. A strong therapeutic alliance, appropriate timing, and consideration of the meaning of medication for the patient must accompany the following established elements: review of all medications, identification of medications that could be ceased or reduced, collaborative planning of the deprescribing regimen, and provision of review and support to the patient and caregivers. The authors discuss how deprescribing might be adapted for and implemented in psychiatry, identify potential barriers, and make recommendations for future directions.

PMID:
26975524
DOI:
10.1176/appi.ps.201500359
[Indexed for MEDLINE]

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