Ensuring the Least Restrictive Medication
A Guide for Carers Using the Maudsley Deprescribing Guidelines
The overuse of psychotropic drugs is a significant concern in healthcare, aged care, and disability services. This issue has been highlighted during several Disability Royal Commission hearings, bringing to light the need for more responsible prescribing practices and better support for individuals affected by these medications.
On Wednesday, 12 March 2025, the
Striking the Balance forum featured keynote speakers Dr. Mark Horowitz, an expert in psychotropic drugs and author of the
Maudsley Deprescribing Guidelines, and Professor Julian Trollor, Director of the
National Centre of Excellence in Intellectual Disability Health. These experts shared valuable insights into the challenges and solutions related to the overuse of psychotropic drugs.
Deprescribing: Is the process of tapering or stopping medications that may no longer be necessary or beneficial. It aims to minimise medication burden and reduce the risk of side effects and dependency
Dr. Horowitz emphasised the importance of deprescribing guidelines to help healthcare providers reduce the reliance on psychotropic medications. His Maudsley Deprescribing Guidelines offer a structured approach to safely tapering off these drugs, ensuring that patients receive appropriate care without unnecessary medication.
Professor Trollor highlighted the need for comprehensive health assessments and personalised care plans for individuals with intellectual disabilities. He stressed that psychotropic drugs should not be the first line of treatment and that alternative therapies and supports should be considered to address behavioural and mental health issues.
Steps for Carers to Ensure Least Restrictive Medication
- Comprehensive Assessment:
Begin with a thorough assessment of your loved one's current medications, health status, and behavioural needs. Collaborate with healthcare professionals to understand the necessity of each medication and identify potential candidates for deprescribing. - Educate Yourself and Your Loved One:
Familiarise yourself with the Maudsley Deprescribing Guidelines and educate your loved one about the benefits and process of deprescribing. Understanding the guidelines can empower both of you to make informed decisions about medication management. - Collaborate with Healthcare Providers:
Work closely with doctors, pharmacists, and other healthcare providers to develop a personalised deprescribing plan. Ensure that the plan includes gradual tapering schedules, monitoring for withdrawal symptoms, and strategies for managing any challenges that may arise.
- Monitor and Support:
Regularly monitor your loved one's progress during the deprescribing process. Be vigilant for any signs of withdrawal or changes in behaviour. Provide emotional support and reassurance to help them cope with the transition.
- Use Non-Pharmacological Interventions:
Explore non-pharmacological interventions that can support your loved one's health and well-being. This may include behavioural therapies, lifestyle changes, and other supportive measures that can reduce the need for medication. - Advocate for Your Loved One:
Advocate for your loved one's right to receive the least restrictive medication. Ensure that healthcare providers consider their preferences and needs when making decisions about medication management.
The overuse of psychotropic drugs in healthcare, aged care, and disability services is a pressing issue that requires immediate attention. By adopting deprescribing guidelines and personalised care plans, carers and healthcare providers can work together to ensure that individuals receive the most appropriate and effective care.
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