Deprescribing or Tapering Psychiatric Medications (lexapro, effexor, paxil, klonopin, xanax others)

Dr. Pagnani of Rittenhouse Psychiatric Associates discusses the tapering or "deprescribing" of Psychiatric Medications including SSRIs (lexapro), SNRIs (effexor), Benzodiazepines (klonopin, xanax) and even buprenorphine. Patients who have taken medication for years, and failed at tapering or stopping these medications due to withdrawal ("brain zaps," muscle twitches, headaches, dizziness, anxiety, insomnia) may benefit from treatment with a provider specifically trained in tapering these medications. Additionally, Rittenhouse Psychiatric Associates providers can work with local compounding pharmacies to create doses in-between manufacturer made doses of these medications, to make the process of tapering or deprescribing as easy as possible. Sometimes when a patient undergoes this process, they find that the medication actually IS very helpful for their mood, anxiety or other symptoms, but they may not need the full dose that they have taken for years. This is NOT a failure, and can result in a decrease in side effects (and improved quality of life). Patients who have felt over-medicated, dull, cognitively slowed, or excessive sleepiness, may find that at a lower dose, they have an improved quality of life, and still have symptom control. Psychiatric medications can be incredibly important for an individual's care, and should never be decreased or stopped without consulting directly with a mental health professional. However, just because someone was started on a medication, or just because they have withdrawal when they try to decrease it, doesn't mean that they need to stay on it "forever."
Dr. Pagnani is the founder and medical director of Rittenhouse Psychiatric Associates, an Instructor at The Johns Hopkins Hospital for the Department of Psychiatry, he supervises psychiatric residents at Jefferson Hospital, he serves on the Young Professional Board of Uplift, the Center for Grieving Children and he maintains a private practice of Psychiatry in Philadelphia where he sees patients for one-time psychiatric evaluations and second opinions. He is a licensed physician and surgeon in NJ, PA, NY, MD, DE, FL and CA and can provide consultations to individuals via HIPAA compliant Telehealth visits living in these locations.
Rittenhouse Psychiatric Associates is a private practice of psychiatry consisting of about 25 psychiatrists, psychiatric nurse practitioners and psychotherapists with physical locations in Philadelphia and Paoli, PA and serving all of PA, NJ, NY and FL virtually via HIPAA compliant tele-psychiatry (Patient initial visits must be in-office, regardless of provider state licensing). Individuals seeking not only evaluations but long-term psychiatric care, can contact Rittenhouse Psychiatric Associates directly.
These videos aim to increase awareness and discussion of mental health topics and to encourage struggling individuals to schedule an appointment directly with a mental health provider. Mental health needs to be normalized, and simply speaking about mental health topics openly, is an important first step.
This video is INFORMATIVE ONLY - NOT MEDICAL ADVICE.
If you are researching a specific topic, please view our UA-cam channel, click all videos and use the search function. Please also visit and follow us on instagram and FB: @RittenhousePsych.
www.RittenhousePA.com
www.ChrisPagnaniMD.com