The clinic helps people to stop psychiatric medications prescribed for common mental health conditions (like anxiety, depression, distress and insomnia) that are no longer needed or no longer wanted. The clinic is for people who are looked after in primary care (but not under secondary care psychiatric services)

We are now open to referrals from any GP in England (see referral form). 

These medications (with example brand names in brackets) include:

• Antidepressants such as citalopram (e.g. Cipramil), duloxetine (e.f. Cymbalta), escitalopram (e.g. cipralex), fluoxetine (e.g. Prozac), fluvoxamine (e.g. Faverin), mirtazapine (e.g. Remeron), paroxetine (e.g. Seroxat), sertraline (e.g. Lustral), and venlafaxine (e.g. Efexor).
• Benzodiazepines such as diazepam (e.g. Valium), and lorazepam (e.g. Ativan).
• Z-drugs, such as zopiclone (e.g. Zimovane), and zolpidem (e.g. Stilnoct). 
• Gabapentinoids, such as pregabalin (e.g. Lyrica), and gabapentin (e.g. Neurontin). 
• Antipsychotics, when prescribed for sleep or mood problems (but not for schizophrenia or bipolar disorder) such as quetiapine (e.g. Seroquel).

While these medications can be helpful, sometimes people take them for longer than they need. The side effects of the medication (e.g. emotional blunting, memory or concentration impairments, fatigue, weight gain, sexual side effects, gastrointestinal disturbance, etc) can also outweigh the benefits. The benefits of  these medications may also wear off over time so they become less useful. 

Some people’s conditions will have improved, they may have found other ways to manage it, or they simply may wish to stop the medication for personal reasons. 

We know that stopping can be difficult because of:

• withdrawal symptoms (unpleasant mental or physical symptoms that arise because you have become used to the medication), that can sometimes be mistaken for a relapse or return of an underlying condition, or 
• because of a return of the condition for which you were prescribed the medication. 

Our clinic can reduce the chance of these effects by overseeing gradual reductions of the medication done at your pace (using different options to allow for very small reductions), with support from our specialised staff, who are skilled in careful deprescribing. The staff at the clinic include people who have themselves stopped these psychiatric medications. 

Clinicians in the service are:

• Dr Mark Horowitz
• Professor Joanna Moncrieff
• Dr Louise Bundock

If you are interested in stopping one of your medications or simply want to find out more about the possibility, ask your GP to make a referral to our service (National Psychiatric Drug Deprescribing Service), with the link in the sidebar.

More detailed information:

Inclusion criteria for the clinic:

• Over the age of 18
• Any patient who wants to stop their medication – we do not take patients who do not want to stop their medication

Exclusion criteria for the service include:

• Patients who are opposed to stopping their medication 
• Patients who are in crisis or actively suicidal 
• Patients who are under the care of a secondary mental health team
• Patients who do not have a local prescriber
• Patients for whom the risks of deprescribing are deemed too high to be conducted in the community
• Patients with a primary diagnosis of a psychotic disorder, bipolar disorder or dementia. 
• Significant drug and alcohol problems (in which case they may be more suitable for a D+A service)

The service will consist of support over months or longer to guide and support a patient through the process of stopping medication, and any complications that arise. Treating doctors will be informed of progress and will kindly prescribe relevant medications as instructed by the clinic.