Experts Release First Consensus Guidelines on When — and How — to Stop Psychiatric Meds

Washington, D.C. — For the first time, a panel of international experts has reached formal consensus on how and when psychiatric medications should be discontinued in clinical care — a topic that carries particular weight in nursing homes, where psychotropic drugs are widely used and often overprescribed.

The guidance, published in JAMA Network Open, was developed by 45 psychopharmacology specialists from around the world. The group completed a multi-round Delphi survey and a focused literature review spanning January through May of 2025, ultimately reaching agreement on 44 of 50 proposed statements — an 88% consensus rate.

Five Core Takeaways

The panel landed on five key principles for deprescribing psychotropic medications:

• Don’t stop a drug without first checking whether the patient has actually been taking it
• Consider discontinuation when there’s been less than a partial response, or when treatment goals have been met and relapse prevention isn’t needed long-term
• Psychological effects of stopping medication deserve attention in their own right
• Close clinical monitoring must follow any deprescribing decision
• Patients should be active participants in risk-benefit discussions — not bystanders

“The process should be deliberative, thoughtful and proactive,” the authors wrote, “with continual reassessment of treatment aims and goals, awareness of alternatives, degrees of success or failure.”

A Fluid Process, Not a One-Time Call

The panel pushed back against the idea of deprescribing as a single event. Prescribing, renewing, and stopping medications should all be viewed as part of a continuous, collaborative process — one that evolves as a patient’s condition changes over time.

That framing matters in long-term care settings, where residents’ health can shift significantly and medication regimens often go unchallenged for months or years. Industry reports have long flagged the overuse of antipsychotics in nursing homes as a persistent quality concern.

The new consensus doesn’t set hard rules for when to stop specific drugs. Instead, it lays out a framework for making those calls more deliberately — with patients involved, outcomes monitored, and no assumptions made that what worked at admission still makes sense a year later.