You’ve been on your medication for a while now. Maybe months, maybe years. And it helped — truly helped — during a period when you needed it most. But lately, a question has been forming: Is it time? Am I still the person who needs this medication? What would it feel like to try without it?
These are reasonable questions, and they deserve a thoughtful answer — not a reflexive one. Because the truth about deprescribing psychiatric medication is that it’s more nuanced than most people realize. It’s not as simple as “you feel better, so you can stop.” And it’s not as scary as some of the internet would have you believe. But it does require clinical attention, individualized planning, and the kind of patient-provider partnership that makes the process feel safe rather than reckless.
At InnerClarity, deprescribing is something I support when appropriate, guide, and take seriously as a clinical skill. I’ve also had clients for whom remaining on medication was the right decision — and I take that equally seriously. This post is designed to help you understand what deprescribing actually involves, how to know whether it might be appropriate for your situation, what the process looks like when it’s done well, and how to make an informed decision in collaboration with your provider.
What Deprescribing Actually Means
Deprescribing is the planned, supervised, gradual reduction of a medication when it may no longer be necessary, when risks outweigh benefits, or when the patient and provider collaboratively determine that tapering is clinically appropriate. It is a deliberate clinical process — not the same thing as suddenly stopping a medication or skipping doses.
The term has gained increasing attention in psychiatry as clinicians recognize that while starting medication gets significant attention and protocol, the process of stepping down from medication often receives far less. A growing body of literature, including a review published in Therapeutic Advances in Psychopharmacology, argues that deprescribing should be considered an essential component of good prescribing practice — not an afterthought (Gupta & Cahill, 2016).
When Deprescribing May Be Appropriate
Not everyone on psychiatric medication should taper off. For some individuals and some conditions, long-term medication is the most effective and appropriate clinical choice — and staying on treatment that supports your stability is a completely valid decision with no expiration date.
That said, deprescribing may be worth discussing when symptoms have been stable for an extended period and you and your provider are confident that the condition is well-managed, when life circumstances that originally contributed to your condition have meaningfully changed, when you are experiencing side effects that affect your quality of life and the risks of continuing may outweigh the benefits, when you have built a strong foundation of non-medication coping strategies — lifestyle habits, therapeutic skills, social support — that can sustain your wellbeing without pharmacological support, or when a medication was initiated for an acute episode (such as situational depression or a crisis-related anxiety spike) and the acute phase has resolved.
The decision should be collaborative, informed, and unhurried. It should account for your diagnosis, your treatment history, how long you’ve been stable, what support structures are in place, and your own goals and preferences.
When Deprescribing Is Not Appropriate
Equally important is recognizing when tapering is not the right path. Deprescribing may not be appropriate when your condition is chronic and has historically required medication for stability (such as recurrent major depression, bipolar disorder, or chronic anxiety disorders), when you have experienced relapse during previous attempts to discontinue, when your current stability is largely attributable to medication and no adequate non-medication supports are in place to maintain that stability, when you are currently navigating significant stress, life transitions, or destabilizing circumstances that increase relapse risk, or when the medication is effectively managing a condition with high relapse rates and the consequences of relapse would be clinically significant.
Choosing to remain on medication that is working well for you is not a failure, a weakness, or a sign that you’re “dependent.” It is a clinical decision made in the interest of your health and stability — no different from someone with a thyroid condition choosing to remain on thyroid medication because it’s what keeps them well.
What the Tapering Process Looks Like
When deprescribing is clinically appropriate, it requires careful planning. This is not a process that should be rushed, improvised, or attempted without clinical guidance.
Developing an Individualized Plan
There is no one-size-fits-all tapering schedule. The plan I develop accounts for the specific medication and its pharmacological properties (some medications require slower tapers than others), how long you have been taking it (longer duration generally warrants a more gradual taper), your current dose, your clinical history — including any previous tapering attempts, what non-medication supports are in place, and your personal preferences and comfort level.
Gradual Dose Reduction
The standard approach is to reduce the dose incrementally over weeks or months, allowing your brain and body to adjust gradually to each reduction. The pace varies by medication and by individual. Some medications — particularly SSRIs and SNRIs — can produce discontinuation symptoms if reduced too quickly. These symptoms (which may include dizziness, irritability, flu-like sensations, insomnia, and “brain zaps”) are physiological responses to the medication being reduced, not evidence that you “need” the medication. However, they are uncomfortable and can be distressing, which is why a slow, measured taper is essential.
A landmark study published in The Lancet Psychiatry found that psychiatric medication tapering should follow a hyperbolic dose reduction curve — meaning the dose reductions should get smaller as the dose gets lower, because the brain’s receptor response is nonlinear (Horowitz & Taylor, 2019). This is a departure from the traditional approach of equal-step reductions and represents an important clinical advancement in how deprescribing should be done.
Close Monitoring Throughout
Throughout the taper, I schedule regular follow-ups to assess how you’re responding — both physically and emotionally. We monitor for discontinuation symptoms (which are temporary and related to the taper itself), returning symptoms (which may indicate that the medication was still providing clinical benefit), and your overall emotional and functional stability.
The distinction between discontinuation symptoms and returning symptoms is one of the most critical clinical judgments in deprescribing. Getting this wrong can lead to either unnecessary reinstatement of medication (if discontinuation symptoms are mistaken for relapse) or premature continuation of the taper (if returning symptoms are dismissed as transient). Close monitoring and open communication between you and your provider are what make this distinction possible.
Flexibility and Responsiveness
A good taper plan is not rigid. If a dose reduction produces significant distress, we can slow down, hold at the current dose longer, or even step back up temporarily before trying again. There is no penalty for adjusting the pace. The goal is a successful, comfortable transition — not adherence to a predetermined schedule at the expense of your wellbeing.
Building Wellness Strategies for the Transition
Deprescribing does not happen in a vacuum. As we taper medication, I help you strengthen the non-medication pillars of your wellbeing — sleep hygiene, nutrition, physical activity, stress management, social connection, and coping strategies. These become increasingly important as the pharmacological support is reduced, and investing in them proactively makes the transition smoother and more sustainable.
Frequently Asked Questions About Deprescribing
Can I just stop taking my medication if I feel better?
No. Abruptly stopping psychiatric medication can produce discontinuation symptoms, rebound effects, or relapse. Even if you feel well, the improvement may be because the medication is working — not because you no longer need it. Any changes to your medication should be made under clinical supervision with a gradual tapering plan if appropriate.
How long does tapering take?
It depends on the medication, the dose, how long you’ve been taking it, and how your body responds. Some tapers take weeks; others take months. Research supports slower tapers with progressively smaller dose reductions, particularly for antidepressants (Horowitz & Taylor, 2019). The pace is individualized and can be adjusted based on your experience.
What are discontinuation symptoms, and are they dangerous?
Discontinuation symptoms are temporary physical and emotional reactions to medication reduction. They can include dizziness, nausea, irritability, insomnia, flu-like sensations, and “brain zaps” (brief electrical-shock sensations). They are uncomfortable but not typically dangerous, and they resolve as your body adjusts. A well-paced taper minimizes these symptoms significantly.
What if I taper and my symptoms come back?
If returning symptoms emerge during or after a taper, that is important clinical information. It may mean the medication was still providing necessary support, or it may mean additional non-medication strategies need to be strengthened. Restarting medication is not a failure — it’s a responsive clinical decision. We can also explore whether a lower dose, a different medication, or enhanced holistic support might be the right next step.
I’ve been on medication for years. Is it safe to come off?
Long-term medication use does not preclude deprescribing, but it does require a more gradual and carefully monitored taper. It’s also important to honestly assess whether the medication is still clinically needed. For some long-term conditions, ongoing medication remains the most appropriate path. For others, a carefully supported taper is very achievable. This decision should be made collaboratively with your provider based on your full clinical picture.
Does InnerClarity support deprescribing?
Yes, when and if appropriate. Deprescribing is part of the medication management services I offer. I approach it with the same thoughtfulness I bring to starting medication — developing individualized tapering plans, monitoring closely, and integrating holistic support throughout the process. I also respect the decision to remain on medication when that is what’s clinically appropriate.
Making an Informed Decision
Whether you ultimately taper off medication or continue it, the most important thing is that the decision is informed, collaborative, and aligned with your clinical reality and personal goals. You should understand why you’re on what you’re on, whether it’s still serving you, and what your options are.
At InnerClarity Psychiatry & Wellness, medication management — including deprescribing — is treated as an ongoing, evolving conversation, not a static decision made once and forgotten. I help individuals across Minnesota and Iowa navigate the full arc of their medication journey: starting thoughtfully, monitoring carefully, adjusting as needed, and stepping down when it’s safe and appropriate.
If you’re considering whether it’s time to taper off your medication — or if you want a provider who will help you make that decision with care and transparency — request a consultation at InnerClarity Psychiatry & Wellness today.
References
Gupta, S. & Cahill, J. D. (2016). A Prescription for “Deprescribing” in Psychiatry. Psychiatric Services, 67(8), 904–907.
Horowitz, M. A. & Taylor, D. (2019). Tapering of SSRI Treatment to Mitigate Withdrawal Symptoms. The Lancet Psychiatry, 6(6), 538–546.
Disclaimer
This blog post is for educational and informational purposes only and is not intended as a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider with any questions you may have regarding a mental health condition. Do not disregard professional advice or delay seeking treatment based on information presented in this blog.
If you or someone you know is in crisis or experiencing thoughts of self-harm or suicide, please contact the 988 Suicide & Crisis Lifeline by calling or texting 988 (available 24/7). For immediate safety emergencies, call 911 or go to your nearest emergency room.
ABOUT THE AUTHOR
Aicha Katty, DNP, APRN, PMHNP-BC, FNP-C, is the founder of InnerClarity Psychiatry & Wellness, a telepsychiatry practice serving individuals across Minnesota and Iowa. She holds a Doctor of Nursing Practice from Winona State University and dual board certifications in psychiatric mental health and family practice.
Deprescribing is a clinical skill Aicha takes seriously — approaching it with the same depth of assessment, individualized planning, and close monitoring she brings to initiating medication. Her prescribing philosophy of “as much as necessary, but as little as possible” reflects a commitment to ensuring that every medication in a patient’s regimen serves a clear clinical purpose. She supports both the decision to taper when appropriate and the decision to continue medication when that is what best serves a patient’s stability and wellbeing.
If you have questions about your current medications or are considering whether deprescribing may be right for you, request a consultation at InnerClarity Psychiatry & Wellness today.
