Welcome to the latest episode of Talking Meds and the PrescQIPP podcast, engaging conversations about medicines-related dilemmas. 
Today Jonathan Underhill, Medicines Clinical Adviser at PrescQIPP, talks to Dr Mark Horowitz about how to safely stop antidepressants and the importance of tapering dose reduction slowly to reduce the risk of withdrawal symptoms.

Dr Mark Horowitz  is a training psychiatrist and Visiting Lecturer in London, and  the lead author of the Maudsley Deprescribing Guidelines (see below). Mark co-authored the recent Royal College of Psychiatrists’ guidance on ‘Stopping Antidepressants’, and has been commissioned by Health Education England to prepare a teaching module on how to safely stop antidepressants for the NHS (coming soon!). 

Mark has experienced the difficulty of coming off psychiatric medications first hand which has informed much of his work.

Useful sources referred to in this episode include:

Dose response curves/Law of Mass action illustrated here (see figure 1)

https://pharmaceutical-journal.com/article/ld/case-based-learning-safe-withdrawal-and-tapering-of-antidepressants

The Maudsley Deprescribing Guidelines: Antidepressants, Benzodiazepines, Gabapentinoids and Z-drugs

https://www.wiley.com/en-gb/The+Maudsley+Deprescribing+Guidelines%3A+Antidepressants%2C+Benzodiazepines%2C+Gabapentinoids+and+Z-drugs-p-9781119823025

RPS members can get free access to the Maudsley Deprescribing Guidelines here:
https://www.vlebooks.com/Account/Logon/RPS

Maudsley Prescribing Guidelines

The Maudsley Prescribing Guidelines in Psychiatry eBook
Register for an NHS England OpenAthens account.

NICE guidelines

NICE guideline on depression in adults – see section 1.4.12 to 1.4.21 for information on stopping antidepressants.

NICE guideline on medicines associated with dependence or withdrawal symptoms - further recommendations on withdrawing antidepressants.

Clinical Knowledge Summary (CKS)

A new episode of Talking Meds will be available every other Friday.
If you have feedback or suggestions for future topics and guests please submit them to talkingmeds@prescqipp.info

PrescQIPP is funded by the NHS for the NHS, and our aim is to improve medicines-related care for patients. We do this by producing high quality evidence-based resources and training, and by facilitating networks between NHS organisations and professionals.

The majority of pharmacists and other healthcare professionals across the UK can access our resources by registering and logging on to our website www.prescqipp.info. If you have any difficulty accessing the website you can email help@prescqipp.info and we’ll aim to sort things out for you.

Find out more about PrescQIPP here: www.prescqipp.info