FREE BOOK!! ANTIDEPRESSENT DEPRESCRIBING A Smarter, Safer Path to Mental Wellness

 

Reasons a clinician might consider deprescribing include:

• A medication may be contributing to suicidal thoughts. Although uncommon, some medications—including certain antidepressants (especially in younger people), some antiseizure medications, and a few other drug classes—can worsen suicidal thoughts in susceptible individuals. If this is suspected, the clinician may adjust or switch the medication rather than simply stop it.
• Reducing medication burden. Taking many medications at once (polypharmacy) can increase side effects, drug interactions, confusion, and falls, particularly in older adults.
• Treating side effects that affect mental health. Some medications can contribute to fatigue, emotional blunting, sleep problems, or cognitive difficulties, which may worsen a person’s overall well-being.
• Lowering overdose risk. For someone at high risk of attempting suicide, clinicians may reduce access to medications that are especially dangerous in overdose or prescribe smaller quantities at a time while ensuring the person still receives appropriate treatment.
• Stopping medications that are no longer needed. If the risks of continuing a medication outweigh the benefits, deprescribing may improve overall health.

At the same time, abruptly stopping an antidepressant is generally not recommended. Suddenly discontinuing many antidepressants can cause withdrawal symptoms and, for some people, can lead to a return or worsening of depression or anxiety. If an antidepressant needs to be stopped, it is usually tapered gradually under medical supervision.

For people with active suicidal ideation, the priority is a thorough assessment, a safety plan, and ensuring they receive appropriate treatment. That treatment may include:

• Continuing or changing medication rather than stopping it.
• Psychotherapy, such as Cognitive Behavioral Therapy or Dialectical Behavior Therapy.
• Close follow-up and support from mental health professionals.
• Additional treatments if depression is severe or not responding to standard therapies.