Tapering After Decades of Use: Adjusting Protocols for Very Long-Term Patients

Patients who have taken a psychotropic agent continuously for 15, 20, or 30+ years present a distinct pharmacological and clinical picture from the trial populations that generated standard discontinuation guidance. Receptor adaptation is more entrenched, comorbid indications fre

Horowitz and Taylor's Hyperbolic Tapering Research: The Science That Changed Everything

For decades, psychiatric drug withdrawal was treated as a quick afterthought. Doctors halved doses, then halved again, then stopped within a few weeks. Patients who reported brutal symptoms were told it was their underlying illness returning. Then in 2019, two clinicians, Mark Ho

The Maudsley Deprescribing Guidelines: What Patients Need to Know

The Maudsley Deprescribing Guidelines represent a significant shift in how clinicians and patients think about stopping psychiatric medications. Published in 2022 by Dr. Mark Horowitz and Professor David Taylor, the guidelines draw on receptor occupancy research to explain why st

The Leaps of Faith We Take Every Time We Write a Prescription

Psychiatry prescribes with confidence it has not earned. The chain of assumptions between a drug and its intended effect is longer and shakier than most clinicians admit.

The Hardest Psychiatric Medications to Discontinue: What the Evidence Actually Says

Not all psychiatric medications are equally difficult to stop. Here is what the evidence says about which drugs cause the most severe withdrawal, and what clinicians can do differently.

Are Antidepressants Overprescribed? The Question the Field Keeps Dodging

When more than 14% of Australians are taking antidepressants, the instinct inside the system is to frame this as a success story. That framing is not just incomplete — it is a way of not asking the harder question.