Expert Panel Recommended 
Regular Review of Common 
Psychotropic Medications 
More Decisions About Deprescribing Needed
Psychotropic medications are often prescribed 
for many complex, difficult-to-treat psychiatric 
disorders and include antidepressants, anti-
anxiety agents, antipsychotics, mood stabilizers 
and stimulants.  New guidance has suggested 
there’s a need for greater recognition of clinical 
psychopharmacology endpoints, including 
instances where specific medications might 
become unnecessary, redundant, contradictory or 
otherwise inappropriate and merit deprescribing.  
By LaTina Emerson
NEW YORK—Psychotropic medications are often 
prescribed for many complex, difficult-to-treat psy-
chiatric disorders, but the use of these medications 
can increase the risk for complicated medication 
regimens, unintended drug interactions and adverse 
drug effects. 
Deprescribing 
of 
psychotropic 
medications—
including 
antidepressants, 
anti-anxiety 
agents, 
antipsychotics, mood stabilizers and stimulants—might 
be recommended for a variety of reasons, but clinicians 
have little guidance to help them make decisions. 
A recent study published in JAMA Network Open 
examined when mental health clinicians should consider 
deprescribing psychotropic medications, and it aimed to 
establish guidance regarding whether and when to stop 
a medication safely and appropriately. The American 
Society of Clinical Psychopharmacology convened 
an international task force that used a survey and 
literature review to identify clinical situations favoring 
psychotropic drug deprescribing, which is the purposeful, 
supervised discontinuation of medications deemed 
inappropriate for a patient.1
“The basic concept with deprescribing is identifying 
when a medicine is appropriate,” Joseph F. Goldberg, MD, 
clinical professor of psychiatry at the Icahn School of 
Medicine at Mount Sinai and immediate past president of 
the American Society of Clinical Psychopharmacology, 
told U.S. Medicine. “That means it’s not aligned with the 
ailment and diagnosis that a patient is dealing with, the 
side effects outweigh the benefits, the patient is misusing 
the medicine, the medicine is obsolete, or there’s a 
negative reaction that contradicts another medicine. We 
wanted to raise awareness on the part of practitioners to 
initiate dialogues with their patients and not just blindly 
keep represcribing. We were dismayed to see how much 
prescribing goes on without this process.”
The study found that clinicians should regularly and 
systematically evaluate the relevance and appropriate-
ness of all medications in a psychopharmacology regi-
men to determine when monitored deprescribing appears 
necessary. Deprescribing should be considered when the 
benefits of psychotropic medications are absent or the 
risks outweigh the benefits. It also should be considered 
after confirming adequate adherence and weighing the 
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