Deprescribing for Psychiatry: The Right Prescription?

Author(s): John D. Cahill*, Swapnil Gupta

Journal Name: Current Psychiatry Reviews
Continued as Current Psychiatry Research and Reviews

Volume 14 , Issue 1 , 2018


Abstract:

Background: The term “deprescribing” has been coined to describe a specific intervention designed to optimize the reduction or cessation of medications for which benefits no longer outweigh the risks. As a wider concept, it may also come to embody a shifting perspective in the management of chronic illnesses where multiple, changing factors add complexity and nuance to the risk/benefit calculations that underlie prescription. Despite a burgeoning literature in geriatric medicine and palliative and primary care, the term is only recently being introduced to psychiatry.

Objective: This article seeks to raise the question of whether deprescribing may be useful as a construct, clinical intervention and novel field of research in the field of psychiatry.

Method: A focused review of the literature is used to provide context and frame some arguments for and against the adoption of deprescribing concepts and practice in psychiatry at this time.

Results: With both potential risks as well as benefits, the relative expertise in complex shared decision- making and psychosocial aspects of prescribing, mean the specialty of psychiatry has much to gain from and contribute to the field of deprescribing.

Conclusion: Existing deprescribing guidelines may be adapted to guide initial implementation strategies in psychiatry. These should then undergo rigorous clinical trials to establish effectiveness and/or identify populations of most benefit. Further research is warranted to help guide decisionmaking around long-term psychotropic use.

Keywords: Deprescribing, psychotropic medication reduction, psychosocial, polypharmacy, anti-epileptic drug, antipsychotic drug.

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Article Details

VOLUME: 14
ISSUE: 1
Year: 2018
Published on: 30 May, 2018
Page: [4 - 11]
Pages: 8
DOI: 10.2174/1573400514666180531095016
Price: $65

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