Deprescribing in Psychiatry

Abstract

With the growth of polypharmacy across medicine, the concept of deprescribing—reducing or eliminating the use of medication—is gaining traction among prescribers in a range of specialties. Applying this concept to psychiatry is more complex than in other fields of medicine and requires expanding the intervention to include consideration of psychological, social, environmental, and cultural factors. Taking a recovery-oriented and strengths-based approach, this book outlines the need for deprescribing in psychiatry and expands on the intervention to look at barriers and strategies for addressing them, as well as specific considerations for classes of psychotropic medications. The book is explicitly not against the use of medications but instead promotes a rational approach to considering the reduction of medications when indicated and when agreed upon by both prescriber and patient by promoting the use of shared decision-making and working to minimize risk while maximizing quality of life. The book includes learning objectives, self-assessment quizzes, and case examples to support the reader and provide concrete illustrations of implementation. It is geared toward all prescribers of psychiatric medications and is useful as well for patients, family members, and other mental health practitioners interested in learning more about approaches to making the best, most judicious use of psychiatric medications in mental health.