To the alarm of some physicians, an online do-it-yourself subculture has risen focused on quitting psychiatric medications, The New York Times reported March 17.
The deprescribing movement first began about 25 years ago with peer-support groups forming around withdrawing from psychiatric medications. These small groups turned into websites and online forums where people shared information about how to taper off medications, sometimes with reductions so small they require syringes or precision scales.
In recent years, mainstream psychiatry has begun to catch up to the movement, acknowledging the need for healthcare systems to better help patients get off medication when they are no longer effective or necessary. However, quitting medications can be dangerous with severe withdrawal symptoms, relapse risks and the risk of psychosis, depression flare-ups or suicidal ideation. Relapse prevention can also be time-consuming, especially for physicians who are reimbursed only for 15-minute “med management” appointments.
Some health groups began taking action by updating guidance to acknowledge withdrawal and recommend regular reviews to discontinue unnecessary medications. In 2024, “The Maudsley Prescribing Guidelines in Psychiatry,” a clinical handbook published in the United Kingdom, issued its first “de-prescribing” volume. The American Psychiatric Association’s Council on Research and the American Society of Clinical Psychopharmacology said they are both working on their own guides on how to identify when to discontinue a medication and how to de-prescribe.
“There has never been an incentive in industry to tell people when to stop using their product,” Joseph Goldberg, MD, the ASCP’s president, told the Times. “So it really falls to the nonindustry community to ask those questions.”
But demand for quitting medications has risen, and with it a market of private clinics and companies that can charge thousands of dollars a week to assist withdrawal from psychiatric medications. In many cases, patients take matters into their own hands, using advice from online forums to quit medications, often without telling their physician.
During the pandemic, 25% of American adults were taking psychotropic medication, more than triple the share of adults during the early 1990s.
