Welcome to the 21st WCP Virtual Congress Program Scheduling

There has been growing interest in when and how to stop psychiatric medications, an important element of high-quality prescribing practice. This interest has been generated by the findings that in some patients with psychotic disorders functional outcomes are improved by reducing or stopping medication. There has also been growing recognition that stopping antidepressants, benzodiazepines, gabapentinoids and z-drugs can be more difficult than once thought with the possibility of severe and long-lasting withdrawal symptoms in some patients. There is a lack of guidance on the best manner in which to reduce or stop psychiatric medication to reduce the risk of withdrawal effects or relapse. In this symposium we will outline work being done in a service for Clinical Pharmacopsychology that uses clinical measurements of the effect of psychotropic drugs on psychological functioning in the process of reducing and stopping antidepressants. This innovative approach involves assessment of wanted clinical effects, treatment-induced unwanted side effects and patients’ personal experience of change. We will also present principles, based on PET scanning of receptor occupancy, and analysis of clinical trials, that tapering of psychiatric medications from different classes (antidepressants, antipsychotics, and z-drugs) should probably be tapered more slowly than previously supposed (months and sometimes years), according to a hyperbolic pattern of tapering (smaller and smaller dose reductions as total dose gets lower, and down to very low doses before completely stopping), as has been for instance proposed for antidepressants and antipsychotics. The application of these principles to clinical practice will be outlined.