The Process of Deprescribing

Abstract

Deprescribing of psychotropic medications introduces additional complexities related to the specific context of psychiatric disorders and their cultural meaning. This chapter expands on the process of deprescribing as it relates specifically to psychiatry, taking the five essential steps of deprescribing in general medicine and elaborating on them for use in psychiatry. These include a detailed decision-making process, psychoeducation of both the patient and friends or family, and close monitoring and adaptation during medication reduction. Given the current absence of guidelines in this area, documentation is a key element of the process and is discussed in this chapter. Included are suggested templates to support accurate documentation, including the decision-making process, the patient’s response to medication changes, medication lists with their indications, and the appearance and management of withdrawal symptoms and/or relapse.