Psychiatric Medication Tapering

Comprehensive medication/history review → collaborative goals → individualized taper → regular monitoring → adjust, pause, or slow the taper when needed
Abrupt or overly rapid discontinuation can produce withdrawal symptoms, and those symptoms can sometimes be difficult to distinguish from recurrence of the original psychiatric condition.
Not an anti-medication philosophy, not a promise that every medication can or should be stopped, and not a predetermined timeline. Sometimes continuing medication (or stopping at a lower dose rather than completely discontinuing) is the appropriate clinical decision.

My Approach

A slow, thoughtful, and individualized approach to reducing psychiatric medications.

Psychiatric medications can play an important role in improving symptoms, restoring function, and supporting mental health. But there may also come a time when you begin to wonder whether you still need a medication, whether your current dose is still right for you, or whether you could safely take less.

Making that change deserves the same level of thought and medical care that went into starting treatment.

At Cogniva Psychiatry, I offer individualized psychiatric medication tapering and deprescribing for patients who are interested in carefully reducing or discontinuing psychiatric medications. Rather than following a one-size-fits-all schedule, I utilize a slow and controlled approach based on your medication history, current symptoms, treatment goals, previous experiences with dose reduction, and response throughout the tapering process.

Tapering Deserves Careful Attention

Medication when it helps. Less medication when it doesn't. Thoughtful guidance when it's time to make a change.

Antidepressants, benzodiazepines, mood stabilizers, antipsychotics, sleep medications, and potentially other psychiatric medications if appropriate.

Stopping a psychiatric medication is not always as simple as lowering the dose for a few weeks and stopping.

Discontinuation of some medications can be associated with significant symptoms when they are reduced too quickly or stopped abruptly. The appropriate pace of a taper can also vary considerably from one person to another.

For patients who have taken a medication for a long period of time, take multiple psychiatric medications, have experienced difficulty with previous attempts to discontinue medication, or are particularly sensitive to dose changes, a slower and more individualized approach may be appropriate.

The goal is not to get you off medication as quickly as possible.

My goal is to help you make thoughtful changes while prioritizing your safety, stability, functioning, and long-term mental health.

Why

Medication tapering begins with a comprehensive psychiatric and medication review.

Before making changes, it’s important to understand the full picture: why the medication was originally prescribed, how long you have taken it, how it has affected you, what other treatments you have tried, what happened during previous dose changes, and what you hope to accomplish now.

From there, we’ll work together to develop an individualized plan.

Depending on your circumstances, this may include:

Gradual, stepwise dose reductions
Smaller reductions as the dose becomes lower when clinically appropriate
Regular follow-up throughout the taper
Monitoring for withdrawal symptoms and changes in psychiatric symptoms
Slowing or pausing the taper when necessary
Addressing sleep, anxiety, mood, and other factors that may affect the process
Coordinating with your therapist, primary care physician, or other members of your treatment team when appropriate
Reassessing the overall plan as your needs change

There is no predetermined timeline that every patient is expected to follow. Some tapers may be relatively straightforward. Others may take considerably longer.

The pace should be determined by the individual and not simply by the calendar.

The Goal Isn't Always "No Medication"

This is not an anti-medication practice.

Psychiatric medications can be extremely beneficial, and there are circumstances in which continuing medication may be the best clinical decision.

Deprescribing is about asking a different question:

What medication (and what dose) continues to provide meaningful benefit for you?

For some patients, the ultimate goal may be complete discontinuation. For others, reducing the dose or simplifying a complicated medication regimen may provide meaningful benefits while maintaining stability.

And sometimes, after reviewing the risks and benefits together, continuing a medication may still make the most sense.

The goal is not less medication at any cost. The goal is thoughtful, individualized treatment.

Who May Benefit From a Tapering Consultation?

A consultation may be helpful if you:

Have been taking a psychiatric medication for a long time and are unsure whether you still need it
Want to reduce the number of medications you take
Are experiencing unwanted medication side effects
Feel that your current medication or dose may no longer be necessary
Have tried to stop a medication before and had difficulty
Experienced significant symptoms after a previous dose reduction
Are concerned about withdrawal symptoms
Want medical guidance rather than attempting to taper on your own
Would like a psychiatrist to review your overall medication regimen and discuss whether deprescribing may be appropriate

You do not need to arrive with the decision already made.

A tapering consultation can simply be an opportunity to review your treatment history, discuss the potential benefits and risks, and determine whether reducing medication makes sense for you.

Tapering and deprescribing support for a variety of psychiatric medications, including:

Antidepressants
SSRIs, SNRIs, and other antidepressant medications
Benzodiazepines and anxiety medications
Sleep medications
Mood stabilizers
Antipsychotic medications
Stimulant and ADHD medications
Other psychiatric medications

Every medication and every patient is different. The appropriate approach depends on the medication, dose, duration of treatment, diagnosis, other medications being taken, medical history, and individual response to dose changes.

Who We Are

Every decision we make is shaped by a clear sense of purpose. Our journey has been anything but ordinary. Through every step, we've focused on staying true to our values and making space for thoughtful, lasting work.

We believe in simple ideas, strong relationships, and lasting impact. What began as a passion project has evolved into something more. We’re proud of where we’ve been and even more excited for what’s ahead.