Psychiatry is beginning to give more serious attention to deprescribing: the supervised reduction or discontinuation of psychiatric medications when they are no longer useful, necessary, or tolerable.
Prominent psychiatrists are developing guidance on how and when patients should taper off medications. The experts, whose recommendations appeared in the Journal of the American Medical Association Network Open and the British Journal of Psychiatry, identified several structural problems: few clinical trials show when stopping is advisable, many providers do not routinely review long-term prescriptions, and medical training emphasizes starting drugs far more than stopping them. Dr. Joseph Goldberg described the common clinical question: “Why are you still on this medicine?”
The new recommendations try to steer a middle path between overprescribing and blanket rejection of psychiatric medication. Some patients may need medication indefinitely, while others may benefit from careful tapering, fewer drug combinations, and more shared decision-making. The broader lesson is that good medicine requires not only knowing when to prescribe, but also knowing when and how to stop.