David M. Taylor, Mark Horowitz

The Maudsley Guidelines for De-prescribing (eBook, PDF)

• Format: PDF

Produktdetails

• Verlag: John Wiley & Sons
• Seitenzahl: 112
• Erscheinungstermin: 4. Januar 2024
• Englisch
• ISBN-13: 9781119823018
• Artikelnr.: 69861822

Autorenporträt

Mark Horowitz, BA, BSc(Med), MBBS(Hons), MSc, GDipPsych, PhD, is a trainee psychiatrist and Clinical Research Fellow at North East London NHS Trust, where he runs a psychiatric drug deprescribing clinic. He is an Honorary Research Fellow at University College London and he co-authored the Royal College of Psychiatrists guide on 'Stopping antidepressants'. He has authored multiple academic papers on how to safely stop psychiatric drugs in high impact journals, and lectured on this topic around the world to doctors, pharmacists and the public. He was commissioned by Health Education England to prepare a module on safe deprescribing of antidepressants for prescribers in the National Health Service (NHS). He has lived experience of stopping psychiatric drugs which informs most of his work. David Taylor, PhD, FFRPS, FRPharmS, FRCPEdin, FRCPsych(Hon), is Director of Pharmacy and Pathology at the South London and Maudsley NHS Trust and Professor of Psychopharmacology at King's College, London. He is the lead author of the Maudsley Prescribing Guidelines in Psychiatry and Editor-in-Chief of Therapeutic Advances in Psychopharmacology. He co-authored the Royal College of Psychiatrists guide on 'Stopping antidepressants'. His pharmacy department ran a medication help-line for a decade which fielded queries largely related to withdrawal from psychiatric drugs. He has personal experience of stopping psychiatric drugs.

Inhaltsangabe

Preface ix

Acknowledgements xii

Notes on Using the Maudsley(r) Deprescribing Guidelines xiii

Abbreviations List xv

Chapter 1 Introduction to Deprescribing Psychiatric Medications 1

Deprescribing as an Intervention 1

The context for deprescribing 2

Why deprescribe? 7

Barriers and facilitators to deprescribing 11

Withdrawal Effects from Psychiatric Medications 13

Mis-diagnosis of withdrawal effects as relapse 13

Pathophysiology of psychiatric drug withdrawal symptoms 16

Clinical aspects of psychiatric drug withdrawal 19

Specific issues in psychiatric drug withdrawal 23

How to Deprescribe Psychiatric Medications Safely 27

The neurobiology of tapering 28

Practical options for prescribing gradually tapering doses 36

Psychological aspects of tapering 43

Tapering psychiatric drugs in practice 45

Further topics 52

Chapter 2 Safe Deprescribing of Antidepressants 57

When and Why to Stop Antidepressants 57

Adverse effects of antidepressants 66

Discussing deprescribing antidepressants with patients 72

Withdrawal Effects from Antidepressants 76

Recent developments in the understanding of antidepressant withdrawal 76

Pathophysiology of antidepressant withdrawal symptoms 80

Clinical aspects of antidepressant withdrawal 87

How common, severe and long- lasting are withdrawal symptoms from antidepressants? 92

Protracted antidepressant withdrawal syndrome 96

Post- SSRI sexual dysfunction 98

Factors influencing development of withdrawal effects 99

Stratfiying risk of antidepressant withdrawal 105

Distinguishing antidepressant withdrawal symptoms from relapse 107

Distinguishing antidepressant withdrawal symptoms from new onset of a physical or mental health condition 111

Withdrawal symptoms during antidepressant maintenance treatment or switching medication 113

How to Deprescribe Antidepressants Safely 115

Tapering antidepressants gradually 119

Hyperbolic tapering of antidepressants 125

Practical options in prescribing gradually tapering doses of antidepressants 131

Psychological aspects of antidepressant tapering 140

Tapering antidepressants in practice 143

Managing complications of antidepressant discontinuation 153

Tapering Guidance for Specific Antidepressants 158

Agomelatine 159

Amitriptyline 163

Bupropion 168

Citalopram 174

Clomipramine 183

Desvenlafaxine 188

Dosulepin 193

Doxepin 198

Duloxetine 203

Escitalopram 209

Fluoxetine 216

Fluvoxamine 223

Imipramine 228

Lofepramine 233

Mirtazapine 238

Moclobemide 243

Nortriptyline 248

Paroxetine 253

Phenelzine 259

Sertraline 264

Tranylcypromine 270

Trazodone 275

Venlafaxine 280

Vilazodone 288

Vortioxetine 292

Chapter 3 Safe Deprescribing of Benzodiazepines and Z-drugs 297

When and Why to Stop Benzodiazepines and Z-drugs 297

Discussing deprescribing benzodiazepines and z-drugs 304

Withdrawal Symptoms from Benzodiazepines and Z-drugs 309

Physical dependence vs addiction in use of benzodiazepines and z-drugs 311

Pathophysiology of benzodiazepine withdrawal syndrome 313

Variety of withdrawal symptoms from benzodiazepines and z-drugs 316

Rezensionen

"This book provides a unique and detailed guide to deprescribing psychiatric medication. It is a welcome companion volume to the Maudsley Prescribing Guidelines in Psychiatry which have been essential and highly valued reading for psychiatrists for the past 30 years."
--Professor Wendy Burn, Past President Royal College of Psychiatrists

"Psychiatrists are bombarded with information on how to start and continue medications for their patients. However, they receive little or no information on how and when to decrease or stop medications. These guidelines fill that gap."
--Sir Professor Robin Murray, Professor of Psychiatric Research

"Since we began using psychiatric medications 60 years ago, the focus has been on prescribing- with almost no attention to withdrawal symptoms & how often they're confused with relapse. Any clinician can prescribe drugs; it takes art, science, and people skills to deprescribe them."
--Professor Allen Frances, Professor Emeritus of psychiatry at Duke University and head of the DSM-IV committee