Garden State Medical Group
November 7, 2026

Deprescribing Medications: How to Safely Cut Back

Deprescribing Medications: How to Safely Cut Back

Deprescribing is the planned, supervised process of lowering the dose of a medicine or stopping it when the risks outweigh the benefits. It is done with your clinician, never alone. UpToDate describes it as a way to manage polypharmacy and improve outcomes by reviewing your medicines and reducing or stopping those with an unfavorable balance of benefits and harms. This guide explains how the process works, how tapering is handled, and what to bring to a visit.

Garden State Medical Group
Review Your Medicines With a Clinician
Garden State Medical Group provides primary care in North Bergen and Secaucus, where you can discuss your medicines with a healthcare provider.
Visit Garden State Medical Group

TL;DR

  • Deprescribing means cutting down or stopping a medicine with a health care professional, because its harms may now outweigh its benefits.
  • Do not stop a prescription on your own. Some medicines can be stopped right away, while others, such as beta blockers, benzodiazepines and antidepressants, need a slow taper.
  • The first step is a complete medication list: what you take, why, how often, and how it fits your health goals.
  • Older adults are more sensitive to side effects, so regular medication reviews matter more with age.
  • Bring every pill bottle, supplement and over-the-counter product to your appointment so your clinician can see the whole picture.

Table of Contents

What deprescribing means

Most health care is built around starting treatments. The American Academy of Family Physicians notes that guidelines usually explain how to start medications but not how to stop them. Deprescribing fills that gap. The same source defines it as adjusting medications down to the minimum effective dose, or stopping them, when a change in your health means the burden or potential for harm is greater than the benefit.

A medicine may be a candidate when it has no clear current reason for use, is not working, is causing side effects, or carries risks that now outweigh its benefits, according to UpToDate. A medicine that was right for you five years ago may not be right today.

Deprescribing is not about taking away care. A JAMA Internal Medicine patient page describes it as slowly and carefully cutting down on unnecessary medications with a health care professional, and says it is safe when supervised. Some medicines can be stopped immediately. Others have to be decreased gradually.

What deprescribing means

Why medicine lists grow, and why they need review

Medication lists tend to grow over time. You may see a cardiologist, a primary care clinician and a specialist, and each one adds something. Add over-the-counter products and supplements, and the list can become hard for anyone to track.

The JAMA Internal Medicine page explains that the chance of having several medical conditions rises with age, and so does the number of medications used to treat them. That can lead to harmful interactions. It also notes that the way the body processes some medicines changes with age, which can shift the balance toward more risk than benefit.

That is why a regular, structured look at everything you take is one of the most useful things you can do for your health. We cover what that visit looks like in our guide to a medication review visit.

The first step: a full picture of what you take

The first step is not stopping anything. According to UpToDate, it is gathering information: what you are taking, any problems with your medicines, and how they fit your health status, goals and preferences. The list should include regular and as-needed medicines, with:

  • the dose and how often you take it
  • how long you have been taking it
  • the reason it was prescribed
  • your own experience with it, including side effects
  • whether you actually take it as prescribed

That last point matters. A 2026 consensus statement from the American Society of Clinical Psychopharmacology, published in JAMA Network Open, says deprescribing should not happen without first assessing adherence. If you have been skipping doses, your clinician needs to know before deciding anything.

Be honest here. Nobody is grading you. The more accurate the list, the safer the decisions.

How you and your clinician decide what to reduce

Once the list is complete, each medicine is weighed for its current and possible future benefits and harms. UpToDate suggests looking for medicines that lack a valid current indication, that cause or contribute to a side effect, or that are not effective, and using shared decision-making to choose what to stop or reduce.

The Agency for Healthcare Research and Quality describes a five-step approach:

  1. Consider all current medications and the reason for each.
  2. Evaluate the risk of harm to you for each one.
  3. Assess each medicine for its potential to be deprescribed.
  4. Create a priority list of what to address first.
  5. Carry out the plan and monitor the results.

The American Academy of Family Physicians outlines a similar path: identify potentially inappropriate medicines, decide whether to reduce or stop, plan the taper, monitor for withdrawal symptoms or a need to restart, and document the outcome.

Why changes happen one at a time

If several medicines are on the table, AHRQ stresses taking a stepwise approach and withdrawing them one by one. That way you and your clinician can tell what each change did. The priority list is built around your side effects, the potential for harm, the potential for benefit and your own motivation.

Your preferences count. If a medicine helps you do something that matters to you, that belongs in the discussion. The 2026 consensus statement says risk-benefit decisions should ideally involve your active participation.

Stopping versus tapering

Not every medicine is handled the same way. Some can be stopped at once. Others need a gradual reduction, and stopping them suddenly can be dangerous. Never make that call yourself.

The CDC’s STEADI framework gives clinicians a simple list of options: stop, switch, or reduce. It also calls for simplifying the dosing regimen, setting up a monitoring plan for side effects, exploring non-drug options and building in patient preferences.

General tapering guidance

For most medicines, UpToDate advises that if there is any doubt about whether a drug can be stopped abruptly, it is safer to taper over weeks to months. A common rule of thumb is a 50 percent reduction every two to four weeks, with monitoring at each step and again two to four weeks after the last dose. For many psychotropic medicines, slower tapers are suggested, in the range of 5 to 25 percent every two to four weeks.

Clinician-guided medication taper ranges and monitoring intervals

These are clinician-level guides, not a schedule to follow at home. Your own plan depends on the medicine, the dose, how long you have taken it and your health.

Medicines that should not be stopped suddenly

A few examples show why supervision matters:

  • Beta blockers and clonidine. A 2024 review of deprescribing blood pressure drugs in frail older adults states that abrupt cessation of beta blockers can cause rebound angina, anxiety, severe high blood pressure and a fast heart rate, and can even cause a heart attack. Clonidine can also cause withdrawal if it is not tapered.
  • Benzodiazepines. The Joint Clinical Practice Guideline on Benzodiazepine Tapering says clinicians should not stop them abruptly in patients likely to be physically dependent, and that dependence can develop within weeks. It suggests initial reductions of 5 to 10 percent every two to four weeks, generally not exceeding 25 percent every two weeks.
  • Antidepressants. The American Academy of Family Physicians says a taper of at least 14 days is best practice, and several months may be needed. Reductions of about 25 percent every four weeks, or 12.5 percent every two weeks, are reasonable. Discontinuation symptoms can include flu-like symptoms, insomnia, nausea, imbalance, sensory disturbances and hyperarousal.

If you feel unwell after a dose change, call your clinician. Do not wait for the next visit. Monitoring after each step is part of the plan, and so is the option to pause or restart.

Deprescribing in older adults

Age changes how medicines behave. A 2020 review of deprescribing in older people explains that older adults are more susceptible to adverse effects because of frailty, reduced physiological reserve and age-related changes in how the body handles drugs. Side effects can also be hard to spot, especially in someone with memory problems who may not be able to describe what they feel.

Tools clinicians use

The American Geriatrics Society Beers Criteria, first released in 1991 and last updated in May 2023, identify medicines that may be inappropriate for older adults. They ask clinicians to weigh advanced age, cognitive and physical impairment, multiple conditions, frailty, kidney function and polypharmacy.

Some examples from the evidence:

  • Acid reducers. The Beers Criteria suggest avoiding proton pump inhibitors beyond 8 weeks without a clear reason, because of possible links to kidney disease progression, fractures and bacterial overgrowth in the small intestine, as described in a review of deprescribing in chronic kidney disease.
  • Sleep and anxiety medicines. Through Choosing Wisely, the American Geriatrics Society advises against using benzodiazepines or other sedative-hypnotics as first-choice treatment for insomnia, agitation or delirium in older adults, as summarized in an American Academy of Family Physicians article. The Joint Guideline recommends tapering benzodiazepines in most adults 65 and older unless there is a compelling reason to continue. A 2020 review cites a study in which 38 percent of people reported withdrawal symptoms when stopping these drugs or Z-drugs, which is why slow tapering matters.
  • Anticholinergic burden. The 2026 consensus statement recommends routinely checking the total anticholinergic load in older adults and working together to reduce medicines with strong anticholinergic activity.

Falls and medicines

The same consensus says that after a fall, or when fall risk is high, clinicians should check orthostatic vital signs (blood pressure and pulse lying and standing) and do a thorough evaluation that may use a standardized tool such as STOPPFall to find medicines that raise fall risk. If falls are a worry in your family, our articles on fall risk assessment and reducing fall risk at home are a good next read.

Mood matters too. If a loved one seems withdrawn or in pain without a clear cause, see our piece on depression in older adults before changing any medicine.

How to prepare for a deprescribing conversation

A little preparation makes the visit far more useful.

  1. Gather everything. Bring every prescription bottle, over-the-counter product, vitamin and supplement, including things you take only now and then.
  2. Write down your side effects. Note dizziness, stomach trouble, sleep changes, confusion or anything that began after a medicine was added.
  3. Be clear about your goals. Tell your clinician what matters most: staying independent, avoiding hospital stays, sleeping better, or taking fewer pills.
  4. Be honest about how you take your medicines. Missed doses and splitting pills change the picture.
  5. Ask about the plan. Ask which medicine will be addressed first, how fast, what symptoms to watch for and who to call.

If you care for a parent, come to the visit with them if they are comfortable with it. A second person can help recall details and keep the plan organized.

Our perspective

We see deprescribing as part of good primary care, not a separate event. The question we ask at a medication review is simple: is each medicine still doing its job for this person today?

Our multidisciplinary approach combines primary care, cardiopulmonary services, on-site diagnostic testing and chronic care programs. We believe that matters here. Decisions about medicines are better when they rest on current information, such as an EKG, blood tests or a pulmonary function test, rather than on guesswork.

We also believe the plan must be personal. Your goals, your history and your preferences shape what we recommend, and any change is made with you, step by step, with follow-up.

Our focus on prevention, chronic disease management and education means you should leave with a clear understanding of what you take and why.

Garden State Medical Group

Review your medicines with Garden State Medical Group

If you live in North Bergen or Secaucus and have questions about your medicines, start with a visit to our primary care team. We can go through your list with you and talk about next steps. If you manage a long-term condition, our chronic care and health programs offer ongoing support, and our on-site diagnostic testing can help inform decisions.

Garden State Medical Group

We see Medicare and Medicaid beneficiaries, families and older adults, and offer telemedicine visits as well as in-person care. Contact us through our website to book. For help understanding how ongoing follow-up works, read our guide to chronic condition monitoring.

FAQ

Is deprescribing safe?

Yes, when a health care professional supervises it. JAMA Internal Medicine notes that some medicines can be stopped immediately while others must be tapered slowly. The risk comes from stopping on your own, especially with heart, mood or sleep medicines.

What is the first step in deprescribing?

The first step is building a full list of your medicines and how they fit your health and goals. UpToDate says this includes the dose, frequency, duration, reason for use and your own experience. Decisions about what to reduce come after that.

How long does a taper take?

It depends on the medicine. UpToDate gives a rule of thumb of reducing the dose by 50 percent every two to four weeks for many drugs, with slower schedules for psychotropic medicines. Your clinician sets the pace and adjusts it based on how you feel.

Can I stop a medicine if I feel fine?

Not without talking to your clinician first. Feeling fine may be a sign that a medicine is working, and some drugs cause withdrawal problems when stopped suddenly. Call your care team and ask whether a review makes sense.

Sources

Have Questions? We Are Here to Help.

Schedule an appointment with our provider to discuss your health needs.

Call (201) 453-2800Request Appointment

More Articles

High Triglycerides: Causes, Numbers and What to Do

What raises triglycerides: diet, alcohol, weight, diabetes, thyroid, liver and kidney disease, and some medicines. Learn your numbers, LDL goals and next steps.

Sinus Infection or Cold? How to Tell the Difference

Not sure if it's a cold or a sinus infection? Learn the signs, the 10-day rule, when antibiotics matter and when to see a doctor in North Bergen or Secaucus.