The Maudsley Deprescribing Guidelines: Antidepressants, Benzodiazepines, Gabapentinoids and Z-drugs. 1st Edition
… “with the express purpose of limiting the damage that we have seen far too many people experiencing – whilst the medical profession has been slow to recognize what has been happening to real life patients.”—from a reviewer
Most formal guidance on psychiatric medication relates to starting or switching medications with minimal guidance on deprescribing medication. In 2023, the World Health Organization and the United Nations called for patients, as a human right, to be informed of their right to discontinue treatment and to receive support to do so.
The Maudsley Deprescribing Guidelines fills a significant gap in guidance for clinicians by providing comprehensive and authoritative information on this important aspect of treatment.
This evidence-based handbook provides an overview of principles to be used in deprescribing. This is derived from fundamental scientific principles and the latest research on this topic, combined with emerging insights from clinical practice (including from patient experts).
Deprescribing Topics Covered
Building on the recognized brand of The Maudsley Prescribing Guidelines, and the prominence of the authors’ work, including in The Lancet Psychiatry on tapering antidepressants (the most read article across all Lancet titles when it was released). The Maudsley Deprescribing Guidelines covers topics such as:
- Why and when to deprescribe antidepressants, benzodiazepines, gabapentinoids and z-drugs
- Barriers and enablers to deprescribing including physical dependence, social circumstances, and knowledge about the discontinuation process
- Distinguishing withdrawal symptoms, such as poor mood, anxiety, insomnia, and a variety of physical symptoms from symptoms of the underlying disorder that medication was intended to treat
- The difference between physical dependence and addiction/substance use disorder
- Explanation of why and how to implement hyperbolic tapering in clinical practice
- Specific guidance on formulations of medication and techniques for making gradual reductions, including using liquid forms of medication, and other approaches
- Step-by-step guidance for safely stopping all commonly used antidepressants, benzodiazepines, gabapentinoids and z-drugs, including fast, moderate and slow tapering regimens or schedules for each drug, and guidance on how to tailor these to an individual
- Troubleshooting issues which can arise on stopping these medications, including akathisia, withdrawal symptoms, acute or protracted, and relapse.
Written for anyone interested in safe deprescribing of psychiatric medications including psychiatrists, GPs, pharmacists, nurses, medical trainees, and interested members of the public. The Maudsley Deprescribing Guidelines is an essential resource on the subject that provides practical guidance on how to improve patient outcomes in this field of medicine.
“This book provides a unique and detailed guide to deprescribing psychiatric medication. It is a welcome companion volume to the Maudsley Prescribing Guidelines in Psychiatry which have been essential and highly valued reading for psychiatrists for the past 30 years.”
?Professor Wendy Burn, Past President Royal College of Psychiatrists
“Psychiatrists are bombarded with information on how to start and continue medications for their patients. However, they receive little or no information on how and when to decrease or stop medications. These guidelines fill that gap.”
?Sir Professor Robin Murray, Professor of Psychiatric Research
“Since we began using psychiatric medications 60 years ago, the focus has been on prescribing- with almost no attention to withdrawal symptoms & how often they’re confused with relapse. Any clinician can prescribe drugs; it takes art, science, and people skills to deprescribe them.”
?Professor Allen Frances, Professor Emeritus of psychiatry at Duke University and head of the DSM-IV committee
592 pages, published in paperback in February, 2024 by Wiley-Blackwell Publisher
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