Deprescribing Insights

Evidence-based articles on medication tapering, clinical protocols, and the science of safe deprescribing.

Patient EducationMay 2, 20265 min read

Informed Consent for Deprescribing: What to Document Before Tapering

Informed consent for stopping a medication receives less attention than consent for starting one, yet the medico-legal and clinical stakes are comparable. Withdrawal phenomena, relapse risk, and the possibility of protracted symptoms after discontinuation of antidepressants, benz

Drug-SpecificMay 1, 20265 min read

Benzodiazepine Equivalency: A Clinician's Reference for Cross-Tapering

Benzodiazepine equivalency tables are routine reference tools when transitioning a patient from a short-acting agent to a long-acting one for the purpose of deprescribing. They are also among the most misapplied resources in psychopharmacology, because the published equivalencies

Clinical GuidanceMay 1, 20265 min read

Prescribing Compounded Liquid Formulations for Precision Tapering

Hyperbolic tapering of antidepressants requires dose decrements far smaller than the lowest commercially available tablet or capsule strength. For many SSRIs and SNRIs, the final months of a taper involve doses that simply cannot be achieved by splitting tablets or counting beads

Drug-SpecificApril 30, 20265 min read

Paroxetine Discontinuation: Managing the Highest-Risk SSRI Taper

Paroxetine produces discontinuation syndrome at a rate and severity unmatched by any other SSRI, attributable to a combination of potent anticholinergic activity, nonlinear pharmacokinetics, and the absence of active metabolites. For the prescriber managing a patient who has been

Clinical GuidanceApril 29, 20265 min read

Using the DESS Scale to Monitor Antidepressant Discontinuation

Clinicians managing psychotropic tapers face a consistent practical challenge: how do you reliably track whether a patient is tolerating a dose reduction, getting worse, or recovering? Verbal reports vary; patients often underreport symptoms to avoid disappointing their prescribe

Drug-SpecificApril 29, 20265 min read

Venlafaxine Tapering: Why Standard Protocols Fail and What Works Instead

[venlafaxine (Effexor)](/resources/medications/effexor) holds an unfortunate distinction among antidepressants: it reliably produces some of the most intense and prolonged discontinuation syndromes of any psychiatric medication in common use. Prescribers who follow standard indus

Clinical GuidanceApril 29, 20265 min read

Hyperbolic Tapering: The Pharmacokinetic Case for Non-Linear Dose Reduction

Antidepressant discontinuation syndrome affects an estimated 56% of patients who attempt to stop treatment, with severity correlating poorly with the absolute dose being reduced and strongly with the proportional change in serotonin transporter (SERT) occupancy. Hyperbolic taperi