Some clinical situations in the long-term management of psychotic disorders may demand a reduction in the dose, or a total cessation of an antipsychotic medication (AP). The APA or NICE provide guidelines for the initiation and continuation of APs but fall short when a clinician is attempting an AP taper. Deprescribing, an intervention developed in geriatric medicine, lends itself well to streamlining medication management in chronic psychotic disorders. It is defined as the systematic reduction and / or cessation of medications whose current or potential risks outweigh their current or potential benefits while considering the patient’s values, medical status and functioning. It is rooted in recovery-oriented care (personal medicine, shared decision making, fostering hope and empowerment), psychopharmacology (pharmacokinetics and pharmacodynamics of APs), evidence based-medicine and good prescribing (consideration of risk – benefit ratios and the sociocultural and intrapsychic context of medication). In practice it requires a strong therapeutic alliance, flexibility and adaptability from the prescriber.  

Format

Recorded webinar, non-interactive, self-paced distance learning activity with post-test.

This presentation was recorded on March 17, 2022.

Learning Objectives

• Define deprescribing  
• List the principles of deprescribing antipsychotic medications  
• List the steps of deprescribing antipsychotic medications  

Target Audience

Nurse/Nurse Practitioner, Pharmacist, Physician Assistant, Psychiatrist 

Instructional Level

Intermediate, Advanced  

Estimate Time to Complete

Estimated Duration: 1.0 hour
Program Start Date: March 17, 2022 
Program End Date: March 17, 2025

Ongoing Interdisciplinary Discussion Board 

After completing the course, engage with colleagues in the mental health field through SMI Adviser's Webinar Roundtable Topics discussion board. This is an easy way to network and share ideas with other clinicians who participate in this webinar. Access through the discussion tab.

How to Earn Credit

Participants who wish to earn AMA PRA Category 1 Credit™, nursing continuing professional development contact hours (NCPD, formerly CNE), or a certificate of participation may do so by viewing the live presentation and completing the evaluation. After evaluating the program, course participants will be provided with an opportunity to claim hours of participation and print an official CME certificate (physicians), NCPD (nurses), or certificate of participation (other disciplines) showing the event date and hours earned.  

Continuing Education Credit

Physicians

The American Psychiatric Association (APA) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

The APA designates this live event for a maximum of 1.0 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. 

Nurses/Nurse Practitioners

The American Psychiatric Nurses Association is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center’s Commission on Accreditation.  

Faculty and Planner Disclosures

The American Psychiatric Association adheres to the ACCME’s Standards for Integrity and Independence in Accredited Continuing Medical Education. Any individuals in a position to control the content of a CME activity — including faculty, planners, reviewers or others — are required to disclose all relevant financial relationships with ineligible entities (commercial interests). All relevant conflicts of interest have been mitigated prior to the commencement of the activity.

Instructor

• Swapnil Gupta, MD is Associate Professor and Medical Director of Ambulatory Psychiatry at Mount Sinai Morningside Hospital. She was trained as a psychiatrist both in India as well as the United States, at SUNY Downstate Medical Center and Yale University, developing the skills of phenomenological, psychodynamic and neurobiological approaches towards distressing psychological experiences. Her current projects include developing educational materials on deprescribing psychotropics and eliciting knowledge and attitudes about deprescribing among psychiatrists. Dr. Gupta reports no financial relationships with commercial interests. 

Planners

• Teri Brister, PhD, LPC, National Alliance on Mental Illness. Reports no financial relationships with commercial interests.
• John Torous, MD, Beth Israel Deaconess Medical Center. Reports no financial relationships with commercial interests.  
• Donna Rolin, PhD, APRN, University of Texas at Austin. Reports no financial relationships with commercial interests.  

Accessibility for Participants with Disabilities

The American Psychiatric Association is committed to ensuring accessibility of its website to people with disabilities. If you have trouble accessing any of APA’s online resources, please contact us at 202-559-3900 for assistance.

Technical Requirements

This internet-based CME activity is best experienced using any of the following:

• The latest and 2nd latest public versions of Google Chrome, Mozilla Firefox, or Safari
• Internet Explorer 11+

This website requires that JavaScript and session cookies be enabled. Certain activities may require additional software to view multimedia, presentation, or printable versions of the content. These activities will be marked as such and will provide links to the required software. That software may be:  Adobe Acrobat Reader, Microsoft PowerPoint, and Windows Media Player.

Optimal System Configuration:

• Browser: Google Chrome (latest and 2nd latest version), Safari (latest and 2nd latest version), Internet Explorer 11.0+, Firefox (latest and 2nd latest version), or Microsoft Edge (latest and 2nd latest version)
• Operating System: Windows versions 8.1+, Mac OS X 10.5 (Leopard) +, Android (latest and 2nd latest version), or iOS/iPad OS (latest and 2nd latest version)
• Internet Connection: 1 Mbps or higher

Minimum Requirements:

• Windows PC: Windows 8.1 or higher; 1 GB (for 32-bit)/2 GB (for 64-bit) or higher RAM; Microsoft DirectX 9 graphics device with WDDM driver; audio playback with speakers for programs with video content
• Macintosh: Mac OS X 10.5 or higher with latest updates installed; Intel, PowerPC G5, or PowerPC G4 (867MHz or faster) processor; 512 MB or higher RAM; audio playback with speakers for programs with video content

For assistance: Contact educme@psych.org for questions about this activity | Contact SMIadviserhelp@psych.org for technical assistance