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Deprescribing:
A Guide for Patients

Understanding Medication Review & Reduction
Dr Basanth Kenchaiah FRANZCP, Cert. Addiction Psych.
General Adult & Addiction Psychiatrist
Delmont Consulting Suites
314 Warrigal Road, Glen Iris VIC 3146
Tel: 03 9834 3600
Stopping a medication sounds straightforward, but depending on which medicines you take and how long you have been on them, the process can range from a simple GP conversation to a carefully coordinated specialist plan. This guide explains the difference, so you know what to expect.

What is deprescribing?

Over time, medicines that were right for you at one point may no longer be the best option, because your health has changed, new medicines have been added, or side effects have accumulated. Deprescribing is the planned, supervised process of reviewing, reducing, or stopping a medication when it is no longer doing more good than harm.

It is not the same as being told to just stop. Most medicines covered by deprescribing conversations require a gradual reduction, sometimes over many months, to allow your body to adjust safely and to avoid withdrawal effects.

The goal isn't fewer pills for its own sake. It is making sure every medicine you take is still the right one for you, right now.

Two types of deprescribing

Not all deprescribing is the same. The process looks very different depending on how many medications are involved and whether any of them carry dependence or interaction risks.

Routine deprescribing

Stopping a single medication

When one medicine is no longer needed (for example, a sleeping tablet after a short course, or an antidepressant after 12 or more months of stable mood), a GP can usually manage a gradual taper over a few weeks. Risks are manageable and the process is well established.

This is the most common scenario, and in most cases it goes smoothly with good monitoring.

Complex deprescribing

Untangling multiple medications

When someone is on several interacting medicines, particularly opioids, benzodiazepines, or antipsychotics, stopping any one of them can affect the others. It requires careful sequencing, specialist input, and longer follow-up.

It's not just harder. It's a fundamentally different process.

Routine Complex
Scope One drug, clear risk/benefit Multiple drugs, interactions, sequencing needed
Risk level Low–moderate
e.g. mild withdrawal		 Higher
rebound, severe withdrawal, disease flares
Who leads it GP-led Specialist or MDT
Typical process Simple taper; review in 4–8 weeks Prioritised cessation plan; extended monitoring over months
Example Stop SSRI after stable mood for 12 months Taper benzodiazepines + opioids + antidepressants in a patient with chronic pain and anxiety
Simple rule of thumb: If it's one medication with no dependence risk and no complex interactions, your GP can lead the way. If you're on multiple medications, or if there's any dependence involved, a specialist approach is usually the safer path.

Could this apply to you?

These are common reasons your doctor might suggest a medication review. They are conversation starters, not diagnoses. If any of these apply to you, it is worth raising with your treating team.

Taking 5 or more regular medications (polypharmacy)
On opioids, benzodiazepines, or antipsychotics long-term
Multiple chronic conditions being managed at once
Previous difficulty stopping or reducing a medication
History of substance dependence or addiction
Living with frailty or significant cognitive decline

What does the process look like?

Deprescribing is always planned and supervised; it is never a case of simply being told to stop. A typical process involves:

1
Your doctor reviews all your medications
This includes prescription medicines, supplements, herbal products, and anything over-the-counter. The aim is to identify medicines where the balance of benefit and risk may have shifted.
2
You talk it through together
Your goals, concerns, and preferences guide the plan. No medicine should be reduced without a clear discussion about the reasons, what to expect, and what to watch for. This is a shared decision, not something done to you.
3
Gradual dose reduction (tapering)
Most medicines require a slow, stepped reduction rather than abrupt stopping. The pace is set to what you can tolerate, not to a fixed schedule. For some medicines, this process takes many months and uses liquid formulations or compounded preparations to achieve very small dose steps.
4
Regular check-ins to monitor how you're going
Your doctor will check in regularly to catch any withdrawal symptoms early and to distinguish them from the original condition returning. These are different things and require different responses.
5
It is always reversible
If symptoms return or the reduction is not tolerated, the dose can be increased again. A deprescribing attempt that does not succeed is not a failure; it provides useful information and can be reattempted at a different time or pace.

Important things to know

Do not stop any prescription medication on your own without talking to your doctor first, even if you feel well. Abrupt stopping can cause withdrawal symptoms and, for some medicines, serious medical events including seizures.
Psychiatric medications carry real relapse risk. Reducing antidepressants, antipsychotics, or mood stabilisers without specialist oversight can trigger a return of the original illness, sometimes more severe than before treatment began. This decision needs careful planning with your psychiatrist, never on your own.
Withdrawal symptoms are not the same as your illness coming back. Symptoms such as dizziness, nausea, flu-like feelings, or electric shock sensations during a taper are usually temporary withdrawal effects, not a sign the original condition has returned. Tell your doctor what you are experiencing so they can help you tell the difference.
Not all side effects mean you should stop a medicine. Sometimes the right response to a side effect is to adjust the dose or switch to a better-tolerated option in the same class, not to stop treatment altogether. Always discuss side effects with your doctor before making any changes.

If addiction has developed, this changes the plan

There is an important difference between physical dependence (an expected adaptation to long-term use of some medicines, which can be managed with a careful taper) and addiction, which is a different condition requiring specialist treatment.

If a prescribed medicine has led to addiction, deprescribing is not the right framework. Simply reducing or stopping the dose in this setting carries serious risk of withdrawal, significant psychological distress, and, in the case of opioids, a high risk of seeking illicit alternatives. If you are concerned this may apply to you, speak with your doctor or ask for a referral to an addiction psychiatrist.

Medicines prescribed as part of addiction treatment, such as buprenorphine or methadone for opioid use disorder, or naltrexone or acamprosate for alcohol use disorder, are not candidates for routine medication review. These are life-saving treatments and any changes must be led by a specialist.

What to ask your doctor

Bringing these questions to your next appointment is a good starting point for a medication review conversation:

Bring a full medication list to every appointment, including over-the-counter products, supplements, and herbal medicines. Many people take more than their doctor has on file, and interactions matter.
This is the patient-facing guide to deprescribing. A companion clinician reference covering the same topic in clinical depth, including prescribing decision frameworks, relapse risk data, and referral criteria, is available at: info-deprescribing-clinician.html

Content informed by: Horowitz MA, Taylor D. Tapering of SSRI treatment to mitigate withdrawal symptoms. Lancet Psychiatry 2019; Kalfas M et al. Incidence and nature of antidepressant discontinuation symptoms: a systematic review and meta-analysis. JAMA Psychiatry 2025; Tutter A. Medication as object. J Am Psychoanal Assoc 2006; Zilcha-Mano S et al. Not just nonspecific factors: the roles of alliance and expectancy in treatment, and their neurobiological underpinnings. Front Behav Neurosci 2019; Australian Deprescribing Network (ADeN): australiandeprescribingnetwork.com.au.

This information sheet is for educational purposes only and does not replace personalised medical advice. Medication decisions must always be made with your treating clinician. Information current as of October 2026.

Dr Basanth Kenchaiah  ·  basanthkenchaiah.com.au  ·  v1.2 · October 2026