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The Maudsley® Deprescribing Guidelines Comprehensive resource describing guidelines for safely reducing or stopping (deprescribing) antidepressants, benzodiazepines, gabapentinoids and z-drugs for patients, including step-by-step guidance for all commonly used medications, covering common pitfalls, troubleshooting, supportive strategies, and more. Most formal guidance on psychiatric medication relates to starting or switching medications with minimal guidance on deprescribing medication. In 2023, the World Health Organisation and the United Nations called for patients, as a human right, to be informed of their right to discontinue treatment and to receive support to do so. The Maudsley Deprescribing Guidelines fills a significant gap in guidance for clinicians by providing comprehensive and authoritative information on this important aspect of treatment. This evidence-based handbook provides an overview of principles to be used in deprescribing. This is derived from fundamental scientific principles and the latest research on this topic, combined with emerging insights from clinical practice (including from patient experts). Building on the recognised brand of The Maudsley Prescribing Guidelines , and the prominence of the authors’ work, including in The Lancet Psychiatry on tapering antidepressants (the most read article across all Lancet titles when it was released). The Maudsley Deprescribing Guidelines covers topics such as: Why and when to deprescribe antidepressants, benzodiazepines, gabapentinoids and z-drugs Barriers and enablers to deprescribing including physical dependence, social circumstances, and knowledge about the discontinuation process Distinguishing withdrawal symptoms, such as poor mood, anxiety, insomnia, and a variety of physical symptoms from symptoms of the underlying disorder that medication was intended to treat The difference between physical dependence and addiction/substance use disorder Explanation of why and how to implement hyperbolic tapering in clinical practice Specific guidance on formulations of medication and techniques for making gradual reductions, including using liquid forms of medication, and other approaches Step-by-step guidance for safely stopping all commonly used antidepressants, benzodiazepines, gabapentinoids and z-drugs, including fast, moderate and slow tapering regimens or schedules for each drug, and guidance on how to tailor these to an individual Troubleshooting issues which can arise on stopping these medications, including akathisia, withdrawal symptoms, acute or protracted, and relapse. Written for anyone interested in safe deprescribing of psychiatric medications including psychiatrists, GPs, pharmacists, nurses, medical trainees, and interested members of the public. The Maudsley Deprescribing Guidelines is an essential resource on the subject that provides practical guidance on how to improve patient outcomes in this field of medicine. Review: Excellent book - Very important book! It makes you feel safe and supported in all situations in life whether you have an elderly parent or a child or need it yourself when it comes to medication. This book gives the feeling: “ I got you”. The book is high quality and trusthworthy book. You can always take this with you to a doctor visit. This book is very good for all professionals and patients but I feel also for general public. This book will save lives. You could have an elderly parent with dementia or be in a stressful situation in life, go through hormone changes etc. and this book could always be there to support you and keep you safe in all life situations when it comes to medication. Because after reading this you might ask for a second opinion or visit a nutrition doctor, dietician or a therapist before starting medication. Forexample many doctors easily advice women to eat antidepressants for hormone changes when there could be other more safe choices. This book is like life insurance and guidance because you never know what life situation you might end up and it can happen fast. When life happens, you don’t always have time to think, especially if you go through a stressful event. Having this book at home and in hospitals and medical centers is so important. Often in nursing homes there is too high medication which can lead to a fall and broken hips and operation. I have been in these situations myself with my elderly parent who had dementia and he was given too high medication. He became dizzy because of the medication, had a fall and later died way too early in his life. A book like this will save lives and could save our loved ones and increase life quality! The cost of this book is nothing compared to the cost of all the fees that might come up with if the medication is not carefully chosen if the medication is necessary at all. Not to mention how expensive it is to have a hip surgery if there is a fall because of too high medication. This book should be in schools and libraries as well for everyone to reach it when needed. I would have given anything at that time to have authority figures to support me when it came to my fathers medication and to have a reference like this. I trust having this book would have made a difference and that my parent would be alive today. Im so happy I found this book and will most definitely study it. All homes should have this book in their bookshelf. This book should also be in all nursing homes and medical centers and in medical schools. I highly recommend this book to everyone! Thank you for the kind hearted, highly professional and caring doctors with real life experience who took all the time to write this courageous book with new cutting edge and important information! Review: This is the ONLY book you need to read about "DEPRESCRIBING" Psychiatric Drug - Dr. Mark Horowitz and Dr. David Taylor's book on psychiatric deprescribing offers a groundbreaking approach rooted in scientific, evidence-based research. Through hyperbolic tapering off of psychiatric drugs, Horowitz and Taylor present a method that challenges conventional western psychiatric practices, promising safer and more effective outcomes for patients who want to come off their psychiatric medications. As a well-respected psychiatrist and scientist, Dr. Horowit's insights provide invaluable guidance for both practitioners and individuals seeking to navigate the complex field of psychotropic medication deprescribing. The Maudsley Deprescribing Guidelines represent a significant contribution to the field of deprescribing, offering a nuanced perspective that includes insight from patient experts with lived experience coming off of psychotropic medications. These guidelines prioritize a "patient lead" hyperbolic taper to support the patients well-being and ultimately help optimize their tapering outcomes. This is an absolute MUST READ for any provider prescribing psychotropic drugs. In today's healthcare landscape, where the overprescribing and long-term use of psychiatric medications are increasingly scrutinized, understanding how to deprescribe safely and effectively is essential. These comprehensive guidelines will absolutely equip practitioners with the tools they need to optimize patient care and minimize potential risks associated with psychotropic drug tapering. A fantastic analogy regarding psychotropic prescribing and deprscribing is likened to learning how to fly a plane. A pilot needs to learn to fly an airplane as well as LAND an airplane safely. Conversely, a provider that that's the knowledge to prescribe psychotropic medications should also have the knowledge and tools to help safely deprescribe. ***Of note****** I am writing this review from the KINDLE version downloaded in the USA as the print edition hasn't been sent from the publisher yet.







| Best Sellers Rank | #48,083 in Books ( See Top 100 in Books ) #40 in Psychiatry (Books) |
| Customer Reviews | 4.6 out of 5 stars 253 Reviews |
L**T
Excellent book
Very important book! It makes you feel safe and supported in all situations in life whether you have an elderly parent or a child or need it yourself when it comes to medication. This book gives the feeling: “ I got you”. The book is high quality and trusthworthy book. You can always take this with you to a doctor visit. This book is very good for all professionals and patients but I feel also for general public. This book will save lives. You could have an elderly parent with dementia or be in a stressful situation in life, go through hormone changes etc. and this book could always be there to support you and keep you safe in all life situations when it comes to medication. Because after reading this you might ask for a second opinion or visit a nutrition doctor, dietician or a therapist before starting medication. Forexample many doctors easily advice women to eat antidepressants for hormone changes when there could be other more safe choices. This book is like life insurance and guidance because you never know what life situation you might end up and it can happen fast. When life happens, you don’t always have time to think, especially if you go through a stressful event. Having this book at home and in hospitals and medical centers is so important. Often in nursing homes there is too high medication which can lead to a fall and broken hips and operation. I have been in these situations myself with my elderly parent who had dementia and he was given too high medication. He became dizzy because of the medication, had a fall and later died way too early in his life. A book like this will save lives and could save our loved ones and increase life quality! The cost of this book is nothing compared to the cost of all the fees that might come up with if the medication is not carefully chosen if the medication is necessary at all. Not to mention how expensive it is to have a hip surgery if there is a fall because of too high medication. This book should be in schools and libraries as well for everyone to reach it when needed. I would have given anything at that time to have authority figures to support me when it came to my fathers medication and to have a reference like this. I trust having this book would have made a difference and that my parent would be alive today. Im so happy I found this book and will most definitely study it. All homes should have this book in their bookshelf. This book should also be in all nursing homes and medical centers and in medical schools. I highly recommend this book to everyone! Thank you for the kind hearted, highly professional and caring doctors with real life experience who took all the time to write this courageous book with new cutting edge and important information!
K**.
This is the ONLY book you need to read about "DEPRESCRIBING" Psychiatric Drug
Dr. Mark Horowitz and Dr. David Taylor's book on psychiatric deprescribing offers a groundbreaking approach rooted in scientific, evidence-based research. Through hyperbolic tapering off of psychiatric drugs, Horowitz and Taylor present a method that challenges conventional western psychiatric practices, promising safer and more effective outcomes for patients who want to come off their psychiatric medications. As a well-respected psychiatrist and scientist, Dr. Horowit's insights provide invaluable guidance for both practitioners and individuals seeking to navigate the complex field of psychotropic medication deprescribing. The Maudsley Deprescribing Guidelines represent a significant contribution to the field of deprescribing, offering a nuanced perspective that includes insight from patient experts with lived experience coming off of psychotropic medications. These guidelines prioritize a "patient lead" hyperbolic taper to support the patients well-being and ultimately help optimize their tapering outcomes. This is an absolute MUST READ for any provider prescribing psychotropic drugs. In today's healthcare landscape, where the overprescribing and long-term use of psychiatric medications are increasingly scrutinized, understanding how to deprescribe safely and effectively is essential. These comprehensive guidelines will absolutely equip practitioners with the tools they need to optimize patient care and minimize potential risks associated with psychotropic drug tapering. A fantastic analogy regarding psychotropic prescribing and deprscribing is likened to learning how to fly a plane. A pilot needs to learn to fly an airplane as well as LAND an airplane safely. Conversely, a provider that that's the knowledge to prescribe psychotropic medications should also have the knowledge and tools to help safely deprescribe. ***Of note****** I am writing this review from the KINDLE version downloaded in the USA as the print edition hasn't been sent from the publisher yet.
R**.
Should be read by prescribers & patients/their families
Excellent book…anyone trying to help themselves or someone else taper off SSRIs after years or use, while minimizing withdrawal effects, should read this book and use the guidelines. The only thing that would make it better is guidelines on how to taper even slower than the slowest taper of 3% RO that is in the book. 0.5% and 1% RO tapers are useful for sensitive people.
I**L
Great Book! Definitely Worth Buying!
This book lists the most common medicines of each type with amounts, and also 3+ different tapering speeds and suggests other speeds if those are not well tolerated. This book gave me and my psychiatrist a common ground to start from. I highly recommend grabbing a copy to donate to your local Mental Health Clinic! This book uses plain English and is written for both patients and clinicians, so discuss!. **On a side note: This book does NOT discuss tapering of antipsychotics. There is no section in the book that mentions antipsychotics. This was disappointing.
L**A
Recommending.
Very informative book for those who understand this topic.
O**O
Amazing Book, Terrible Shipping Experience
This is an incredibly important book for prescribers and patients of these four classes of psychiatric medications. It combines a lot of data that was otherwise scattered on the internet or in other articles and publications, making it easy for anyone to get up to speed on the basic for safe, patient-led deprescribing. My only caveat is that this does not represent ALL the information that is needed, and leaves prescribers and patients to come up with many of the important details such as drug formulation, record keeping, and math formulations on their own. However, it's still an invaluable resource. My only issue was Amazon is currently shipping these paperbacks in a thin bubble mailer; the result is that the spines get absolutely wrecked in transit. I ordered twice and received the two ruined copies pictured in this review. For a $40 book, this deserved a cardboard box.
S**N
100% worth the price!
Tapering off benzodiazepine sleep medication. This book helped my Dr safely taper me. 100% recommended. I know it's costly but most Dr's have no clue and this tells them most everything they need to know. It's a great resource to print copies for friends as well.
C**A
Excellent
Best book to use if you need to taper benzos. Doctors dont have the complete understanding yet. They were trained wrong sadly. Buy it. Use it. Show it to your doctor.
L**D
Paradigm Shifting.
From the desk of a Canadian MD/academic-clinical psychiatrist/concerned family member/patient. Arriving at my door this week, Deprescribing Guidelines was the first medical textbook where upon opening the cover, I read the first 50 pages straight through. In writing my first ever Amazon review, I would be honoured to be considered by Drs. Horowitz and Taylor to be their peer. There is not enough space here to express the potential benefit of this essential desk reference. A hard copy will be gifted to members of my team. My own busy pharmacist distractedly quipped, “they still make textbooks?” and then lit up at the prospect of the guidance therein. I find it HOPEFUL. Let me explain. This volume deals with Antidepressants, Benzodiazepines, Gabapentinoids and Z-Drugs. Simply put, they are used to suppress feelings and sensations. Notwithstanding several good, humane reasons for temporarily doing so, it turns out that taking them long-term changes the brain so we eventually must rely on the drug. It hurts if we don’t take it, from a little to a lot. I came of age in psychiatry training with the hype of the “decade of the brain” when mental disorders were being thought of as genetic diseases and cures were around the corner. Novel medications were heavily marketed and prescribing for even more DSM disorders took off. Since before PROZAC, we have been far too influenced by the profit driven global pharmaceutical industrial complex focused on starting, switching, substituting, and adding more medication to deal with side effects. This has yielded profits for corporations and tenured careers for academics. In my opinion, it has not improved our lot collectively. Now we have more distressed people taking medication for "treatment resistant" conditions and finance a perennial quest for the next pharmaceutical fix. Misdiagnosis of relapse or the addition of a 2nd and 3rd disorder likewise has resulted from drug company propaganda shaping medical education. Very few prescribers know how to support people finish a course of medication treatment well. Many are afraid or unwilling to supervise tapers and have no capacity to interpret the reactive feelings and sensations arising correctly. Unwittingly, in the absence of a HOW-TO MANNUAL like this one, I will admit I have dismissed my own body’s intuition, my patient’s self-reports and so-called unsanctioned internet forums that quietly whispered, “there must be another way”. Product monographs and the medical orthodoxy has it wrong, including the experts whose consensus we rely upon daily (CANMET Guideline psychiatry panelists included). “Expect a possible brief and mild discontinuation syndrome (for SSRI/SNRIs)" is simply untrue for too many situations. With this resource, I can more deftly refute standard medical advice without fear of censure. I can offer students and colleagues tangible direction to assist them in preventing needless suffering or perpetuating iatrogenic neurological injury. I know who to reach out to for a consult in the UK! After the COVID 19 years further aggravated my therapeutic nihilism, disenchantment and burnout, finding the works of critical psychiatrists and learning from champion deprescribers while on sabbatical has been a game changer. I add my voice to the first author speaking from lived experience, as I too have been swept up in the escalation of prescription drug reliance of our own profession. Mark Horowitz is plain speaking in key academic journals and several youtube/podcast interviews. I am circling back to read his mentor, Dr. Joanna Moncrieff's work now. Not since Hungarian Canadian, Dr. Gabor Mate won my respect in a Physician, Heal Thyself sort of way has someone come along and impressed me as much. Pharmacists, Prescribers of all kinds and Citizen Scientists with a personal stake in the safe handling of psychotropic drugs and moreover, the people taking them- all of us can breathe easier now with this resource to hand. Respect is earned by the publisher for throwing the weight of their name behind the project. Since adding a decent chapter on deprescribing to their last Prescribing Guidelines edition in 2021, this new Title was needed. May it begin to remedy the imbalance of credible, accessible solutions for navigating the stopping of neurologically adaptive drugs, that have harmed as many souls (or more) as they have helped. There is a companion Deprescribing Guide in the works covering mood stabilisers, stimulants, antipsychotics and opioids. My only disappointment is that we will have to wait until Volume 2 is released in 2025. Join me in appreciating the authors and their many collaborators for their hard-fought personal and professional journeys to bring this book forward. Like me, they have skin in the game and have shown courage and perseverance to deliver this work on behalf of the common good. Bravo.
M**N
Great resource and information for tapering off of antidepressants and benzodiazepines.
Great resource for anyone wanting to have an understanding on coming off/ tapering from antidepressants or benzodiazepines. Contains examples of how to taper and information on each drug. Mark Horowitz is a co author and is a wonderful advocate and expert here. I recommend this book for those wishing for help and understanding of this incredibly difficult journey for some. I only wish our medical environment would read this as part of their training and use it with patients who struggle here, where it can be as difficult physically and mentally as it gets. An estimated 50% of people struggle with withdrawal from these drugs which can take years.
N**B
The best guidelines for deprescribing
The best guidelines for deprescribing. Should be taught to all doctors, nurses and psychologists, regardless of their field (especially ER doctors, psychiatrists, GPs, neurologists, etc.), so they can recognize withdrawal symptoms or guide safely patients to taper off these medications.
S**N
On of the most useful books in psychiatry
Best book in its field currently. Found out about this from Taperclinic Youtube. Best how to taper guide. I used this instead of my doctor's advice (General Practitioner) to safely taper my medication.
M**A
Imprescindible !!
Meses esperando a que se editase y publicase este manual, imprescindible si estás tomando medicación psiquiátrica o si eres psiquiatra. 30 años seguidos tomando hasta 9 pastillas diarias porque los psiquiatras no saben cómo hacer la reducción y eliminación de la medicación y las confunden con "recaídas". Todos los psiquiatras deberían aprenderse este manual de memoria. Gracias, Dr Horowitz!!
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