Depreskription

Depreskription is the planned, systematic process of reducing or stopping medications that may no longer be beneficial or may cause harm. It is used in clinical practice to minimize polypharmacy, improve safety, and align treatment with current goals.

The process emphasizes patient involvement, shared decision making, and careful monitoring to avoid withdrawal symptoms or symptom relapse.

A typical deprescription process includes a comprehensive medication review, identifying medications for potential stopping or dose reduction, designing a personalized taper plan, implementing the plan, and reassessing at follow-up.

Common targets include long-term benzodiazepines, sedatives, opioids, proton pump inhibitors, and certain antidepressants or antipsychotics that may be taperable after stable periods. It is especially common in older adults and those with polypharmacy.

Evidence suggests that deprescribtion can reduce adverse drug events and improve quality of life, though outcomes vary by drug and patient. Risks include withdrawal effects and symptom recurrence, underscoring the need for careful supervision.

Barriers include patient and clinician fears, time constraints, and fragmented care. Decision aids and tools such as medication reviews, Beers criteria, STOPP/START, and guidelines from national bodies can support practice.

Depreskription is part of broader medication stewardship and is distinct from nonadherence or stopping medications without a plan. It is widely discussed in geriatrics, primary care, and psychiatry.