A Delicate Dance: The Principles and Practice of Deprescribing Antipsychotic Medications-View Presentation

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Video Summary

Dr. Rob Cotez, director of the Clinical Research Program for Psychosis at Grady Health System, introduces a webinar titled "A Delicate Dance: The Principles and Practice of Deprescribing Antipsychotic Medications," featuring Dr. Swapnil Gupta. The webinar delves into the need and methodology for deprescribing antipsychotics, especially when risks outweigh benefits. Dr. Gupta, an Associate Professor at Mount Sinai Morningside Hospital, emphasizes the importance of recovery-oriented care, shared decision-making, and considering patient preferences in the deprescribing process. <br /><br />She explains that sudden cessation of antipsychotics can cause dopamine supersensitivity and withdrawal symptoms. Therefore, a hyperbolic reduction approach in tapering doses is recommended to mitigate these effects. Dr. Gupta also highlights systemic and personal reasons to deprescribe, such as reducing polypharmacy and addressing off-label uses. Various psychosocial interventions, such as peer support and psychoeducation, are suggested to support the process. <br /><br />The webinar also discusses barriers and logistic challenges in outpatient settings, stressing the role of interdisciplinary teams and the importance of creating clinic-wide support cultures. Additionally, Dr. Gupta addresses the ethics of deprescribing, outlining its foundation in patient autonomy and shared decision-making. <br /><br />The session includes practical questions from the audience, addressing logistics in community mental health and systemic changes needed for effective deprescribing. Insights into research gaps and future study avenues to better understand the effects of antipsychotic tapering are also discussed.

Keywords

deprescribing antipsychotics

dopamine supersensitivity

recovery-oriented care

shared decision-making

hyperbolic reduction

polypharmacy

psychoeducation

interdisciplinary teams

patient autonomy

community mental health