Evidence-based articles on medication tapering, clinical protocols, and the science of safe deprescribing.
Benzodiazepine equivalency tables are routine reference tools when transitioning a patient from a short-acting agent to a long-acting one for the purpose of deprescribing. They are also among the most misapplied resources in psychopharmacology, because the published equivalencies
Read more →Hyperbolic tapering of antidepressants requires dose decrements far smaller than the lowest commercially available tablet or capsule strength. For many SSRIs and SNRIs, the final months of a taper involve doses that simply cannot be achieved by splitting tablets or counting beads
Read more →Paroxetine produces discontinuation syndrome at a rate and severity unmatched by any other SSRI, attributable to a combination of potent anticholinergic activity, nonlinear pharmacokinetics, and the absence of active metabolites. For the prescriber managing a patient who has been
Read more →Clinicians managing psychotropic tapers face a consistent practical challenge: how do you reliably track whether a patient is tolerating a dose reduction, getting worse, or recovering? Verbal reports vary; patients often underreport symptoms to avoid disappointing their prescribe
Read more →[venlafaxine (Effexor)](/resources/medications/effexor) holds an unfortunate distinction among antidepressants: it reliably produces some of the most intense and prolonged discontinuation syndromes of any psychiatric medication in common use. Prescribers who follow standard indus
Read more →Antidepressant discontinuation syndrome affects an estimated 56% of patients who attempt to stop treatment, with severity correlating poorly with the absolute dose being reduced and strongly with the proportional change in serotonin transporter (SERT) occupancy. Hyperbolic taperi
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