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

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The document provides a comprehensive overview of a webinar by the American Psychiatric Association on deprescribing antipsychotic medications. This educational session, aimed at healthcare professionals, focuses on the principles and practices associated with reducing or stopping the use of antipsychotics in situations where potential harms may outweigh benefits. <br /><br />Key aspects of the webinar include the need for deprescribing, the principles involved, and the specific steps to follow in this process. Reasons cited for deprescribing include antipsychotic polypharmacy, usage as an augmenting agent, off-label indications, adverse effects, and patient preference. The systematic process involves considering the medical status, functioning, patient values, and preferences.<br /><br />The webinar emphasizes a recovery-oriented approach to prescribing, suggesting deprescribing should be considered if medication hinders recovery. It highlights the importance of gradual tapering to prevent withdrawal symptoms due to the pharmacodynamic properties of antipsychotics, particularly their dopaminergic D2 receptor antagonism. <br /><br />The steps for deprescribing include choosing the right time to initiate it, conducting a medication reconciliation, discussing with patients and their support network, applying psychosocial interventions, and carefully monitoring and adjusting the process based on individual responses and potential relapse indicators.<br /><br />Challenges such as the ethics of deprescribing in the absence of established guidelines, and ensuring that decisions both align with ethical principles and involve shared decision-making with patients, are addressed. The document also emphasizes maintaining a balance between the risks and benefits of stopping medications and aligned with patient preferences, considering psychological and social factors.<br /><br />Finally, it concludes that deprescribing should be conducted transparently, flexibly, and with tolerance for uncertainty to ensure safety and effectiveness, while maintaining ethical standards through autonomy, beneficence, non-maleficence, and justice.

Keywords

deprescribing

antipsychotic medications

American Psychiatric Association

healthcare professionals

withdrawal symptoms

recovery-oriented approach

dopaminergic D2 receptor antagonism

shared decision-making

ethical principles

psychosocial interventions