Deprescribing
Deprescribing is the intentional, supervised process of tapering or stopping a medication that may no longer be needed, may be causing harm, or where the risks now outweigh the benefits.
It is not:
Giving up on treatment
A judgment that the medication was wrong to start
Something done abruptly or without a plan
It is:
Precision medicine — matching treatment to what a person actually needs right now, not what they needed years ago
A collaborative decision between patient and provider
A gradual, monitored process with a clear plan and a way to reverse course if needed
In practice, this might look like:
Revisiting an antidepressant that was started for a situational stressor that has since resolved
Reviewing whether each medication in a multi-drug regimen is still contributing meaningfully
Optimizing underlying health and wellness through assessment of nutritional status, possible deficiencies, gastrointestinal health, inflammation or hormonal imbalance, and other possible contributors
What We Look At Before Making Any Changes
Full medication review — every psychiatric and non-psychiatric medication reviewed together, not in isolation
Remission and symptom reassessment — is the condition that prompted treatment still present in the same way?
Functional workup, where indicated — screening for thyroid, inflammatory, nutritional, or hormonal contributors
Risk stratification — some people and some medications carry higher risk with dose changes than others; this is assessed individually
A specific taper plan, if appropriate — including pace, dose steps, and what to monitor. Slower, more gradual ("hyperbolic") tapering approaches are increasingly supported in the literature, particularly for antidepressants — though the appropriate pace is individualized, not a fixed protocol
A support plan for the gap — identifying what will fill the role the medication was playing, which may include:
Psychotherapy (approaches like CBT, ACT, or EMDR have strong evidence for durable outcomes in depression, anxiety, and trauma)
Structured exercise, which has evidence supporting its effectiveness for mild-to-moderate depression
Sleep and circadian health support
Continued monitoring of functional/metabolic factors identified in the workup
Follow-up and monitoring — scheduled check-ins to track how the person is doing, with a plan to pause or reverse the taper if needed