The Maudsley Deprescribing Guidelines

Antidepressants, Benzodiazepines, Gabapentinoids and Z-drugs

By: Mark Horowitz, David M. Taylor

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Paperback | 15 February 2024 | Edition Number 1

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592 Pages

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25.5 x 17.5 x 2.5

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Comprehensive resource describing guidelines for safely reducing or stopping(deprescribing) antidepressants, benzodiazepines, gabapentinoids and z-drugs for patients, including step-by-step guidance for all commonly used medications, covering common pitfalls, troubleshooting, supportive strategies, and more

Most formal guidance on psychiatric medication relates to starting or switching medications with minimal guidance on deprescribing (stopping) medication. The Maudsley Deprescribing Guidelines fills a significant gap in guidance for clinicians by providingcomprehensive and authoritative information on this important aspect of treatment.

The evidence-based handbook provides an overview of principles to be used in deprescribing, derived from fundamental scientific principles and the latest research on this topic, combined with emerging insights from clinical practice (including from patient experts), allowing prescribers to apply this knowledge to practice.

Building on the recognised brand of TheMaudsley 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), which has influenced NICE guidance on this topic, The Maudsley Deprescribing Guidelines covers topics such as:

Why and when to deprescribe antidepressants, benzodiazepines and z-drugs
Barriers and enablers to deprescribing including physical dependence, social circumstances, and knowledge about the discontinuation process
Distinguishing withdrawal symptoms from dose reduction, such as poor mood, anxiety, and insomnia, 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, gabepentinoids 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.

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