New Deprescribing Guidelines

HG practitioners may be very interested to know about a very helpful new guidebook in The Maudsley Prescribing Series: ‘Deprescribing Guidelines: Antidepressants, Benzodiazepines, Gabapentinoids and Z-drugs‘.

These drugs are the very ones that are commonly prescribed for depression, anxiety, stress, sleep etc, which carry risks of longer-term dependence and harm, and the book’s introductory section contains a lot of valuable information relevant to everyone. It includes the evidence to date about problems that can be experienced when ‘coming off’ antidepressants, benzodiazepines, gabapentinoids and Z-drugs, then step-by-step ‘tapering’ options for about 50 specific drugs (fast, moderate and slow schedules that can be tailored to the individual). Its aim is to assist prescribers, patients and others who work with them to learn the difference between ‘relapse’ and ‘withdrawal’ and more safely navigate what has till now been a serious void in understanding.

The guide is written by trainee psychiatrist Mark Horowitz, PhD and psychopharmacologist Professor David Taylor. Horowitz, a clinical research fellow in the NHS, has himself struggled to come off antidepressants after starting them 15 years ago as a medical student and is currently using the documented methods for his own withdrawal.

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