What Is Deprescribing?
Deprescribing refers to the process of tapering off and eventually discontinuing psychiatric medications that may no longer serve your needs. This process should be carefully managed to ensure safety and effectiveness, and it focuses on addressing medications that:
- Are ineffective for your symptoms.
- Cause significant side effects.
- Interact negatively with other medications.
The goal of deprescribing is not to stop medications arbitrarily but to optimize your treatment plan, ensuring that you are only on medications that benefit you. It is important to have a target for your treatment, and in regards to medications the target should always be to find the lowest effective dose, striking a balance between improvement and side effects.
Psychiatric Medication Interactions: Why They Matter
Psychotropic medications can interact with each other in complex ways, potentially leading to undesirable effects. Common interactions include:
Altered Breakdown in the Liver
Some medications can speed up or slow down the metabolism of other medications in the liver, affecting the level of medication in your body.
Increased Medication Levels
Medications can affect the amount of free (active) medication in the bloodstream, potentially leading to side effects or toxicity. For example, aspirin can increase the amount of free valproic acid in the blood stream.
Excessive Receptor Activity
Combining medications that act on the same receptors can amplify their effects. For example, taking two sedative medications together might result in excessive drowsiness, or combining two serotonin reuptake inhibitors can heighten the risk of serotonin syndrome.
Understanding and managing these interactions is crucial for your safety and wellbeing.
Addressing Ineffectiveness of Psychiatric Medication
Over time working with a mental health prescriber, you may find that you’ve accumulated more and more prescriptions without more and more improvement. You may not wish to be on so many medications, and may not even need them if they haven’t been effective for you. Stopping them without discussing with your prescriber can cause unwanted side effects like flu like symptoms, insomnia, appetite changes, or even seizures depending on which class of medication it is. It is always best to consult with your provider before altering your medication regiment.
Managing Side Effects of Psychiatric Medication
While psychiatric medications can be life-changing, they also come with potential side effects. Some side effects, like mild headaches or gastrointestinal upset, may subside as your body adjusts. Others, however, can persist and significantly impact your quality of life. For example, medications like antidepressants can sometimes lower libido, leading to stress in personal relationships. For some, the side effects might outweigh the benefits, necessitating a discussion with your provider about alternatives.