Tapering (medicine)

In medicine, tapering is the practice of gradually reducing the dosage of a medication, when it is reduced or stopped. Drugs that may be tapered off include opioids,[1] selective serotonin reuptake inhibitors,[2] antipsychotics,[3] anticonvulsants,[4] and benzodiazepines.[5]

Cross-tapering

Cross-tapering refers to the practice of a reducing one drug, while introducing a new medication that is titrated to an effective dose. This can be used, for example, when changing antipsychotic medications.[6]: 156 

Peer support groups

Peer support groups, such as survivingantidepressants.org, provide a medium where those tapering medication can discuss approaches and withdrawal symptoms.[7] Surviving antidepressants advocate for a slower rate of tapering than that used in standard medical practice.[8]: 4  Members of the groups discuss the risks of prescription cascade where withdrawal symptoms or the side effects of a psychotropic medication result in further medication and "kindling" effects where repeated withdrawals may increase the risk of symptoms associated with later withdrawals.[8]: 5 

See also

References
  1. Davis, Mellar P.; Digwood, Glen; Mehta, Zankhana; McPherson, Mary Lynn. "Tapering opioids: a comprehensive qualitative review". Annals of Palliative Medicine. 9 (2): 586–610. doi:10.21037/apm.2019.12.10.
  2. Horowitz, Mark Abie; Taylor, David. "Tapering of SSRI treatment to mitigate withdrawal symptoms". The Lancet Psychiatry. 6 (6): 538–546. doi:10.1016/s2215-0366(19)30032-x. ISSN 2215-0366.
  3. Potla, Shanthi; Al Qabandi, Yousif; Nandula, Savitri Aninditha; Boddepalli, Chinmayi Sree; Gutlapalli, Sai Dheeraj; Lavu, Vamsi Krishna; Abdelwahab Mohamed Abdelwahab, Rana; Huang, Ruimin; Hamid, Pousette (2023-02-07). "A Systematic Review of the Need for Guideline Recommendations; Slow Tapering vs. Maintenance Dose in Long-Term Antipsychotic Treatment: 2022". Cureus. doi:10.7759/cureus.34746. ISSN 2168-8184. PMC 9904861. PMID 36777974.
  4. Schachter, Steven C. (2018). "Determining when to stop antiepileptic drug treatment". Current Opinion in Neurology. 31 (2): 211. doi:10.1097/WCO.0000000000000530. ISSN 1350-7540.
  5. Baandrup, Lone; Ebdrup, Bjørn H; Rasmussen, Jesper Ø; Lindschou, Jane; Gluud, Christian; Glenthøj, Birte Y (2018-03-15). Cochrane Drugs and Alcohol Group (ed.). "Pharmacological interventions for benzodiazepine discontinuation in chronic benzodiazepine users". Cochrane Database of Systematic Reviews. 2018 (3). doi:10.1002/14651858.CD011481.pub2. PMC 6513394. PMID 29543325.
  6. Keks, Nicholas; Schwartz, Darren; Hope, Judy (2019-10-01). "Stopping and switching antipsychotic drugs". Australian Prescriber. 42 (5): 152. doi:10.18773/austprescr.2019.052. PMC 6787301. PMID 31631928.
  7. Hengartner, Michael P.; Schulthess, Lukas; Sorensen, Anders; Framer, Adele (2020). "Protracted withdrawal syndrome after stopping antidepressants: a descriptive quantitative analysis of consumer narratives from a large internet forum". Therapeutic Advances in Psychopharmacology. 10: 204512532098057. doi:10.1177/2045125320980573. ISSN 2045-1253. PMC 7768871. PMID 33489088.
  8. Framer, Adele (2021). "What I have learnt from helping thousands of people taper off antidepressants and other psychotropic medications". Therapeutic Advances in Psychopharmacology. 11: 204512532199127. doi:10.1177/2045125321991274. ISSN 2045-1253. PMC 7970174. PMID 33796265.
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