What Is Meant by "Deprescribing," and Does It Belong in Our Lexicon?

Psychiatric medications don’t only need to be started thoughtfully — they need to be sustained thoughtfully. That’s the core message behind “deprescribing,” a term that entered the medical lexicon in 2003 to describe the process of reviewing, and where appropriate modifying or discontinuing, medications that are no longer serving a patient’s clinical needs.

Dr. Joseph Goldberg, Deputy Editor in Chief of The Journal of Clinical Psychiatry, led an international ASCP task force to develop consensus recommendations on when and how psychiatric medications should be discontinued. Their work starts with a definitional problem: the term has been misappropriated by the antipsychiatry movement to imply that psychiatric medications as a class are harmful and should be eliminated. That’s not what the clinical community means — and reclaiming the term was a deliberate choice.

Proper deprescribing is something most clinicians already do intuitively. It means evaluating whether a drug aligns with the current diagnosis, remains efficacious, has manageable side effects, isn’t pharmacodynamically redundant, and hasn’t simply outlived its usefulness. It also means tapering rather than stopping abruptly, monitoring patients after a medication ends, restarting if symptoms recur, and replacing one medication with a better option when one exists.

The task force chose to retain “deprescribing” over simpler alternatives like “discontinuation” because the latter fails to capture this ongoing, nuanced clinical process. Deprescribing implies a thoughtful, collaborative decision made with the patient — not a unilateral action, and not passive acquiescence to nonadherence.