Consider the benefits of treatment and reduce medicine-related harm. Medicines should be prescribed at the lowest necessary dosage for the minimum period necessary.

If the treatment is ineffective, consider ceasing the medication. A tapered reduction may be necessary to reduce discontinuation effects. Explain the predicted time limit for symptoms during this transition period.  

If the treatment is effective and the condition has been stable, consider reducing the dose and reassessing the effectiveness at a lower dose. If the treatment is effective at this lower dose, this process can be repeated until the current lowest effective dose has been established or the medication has been ceased.

If the treatment has significant adverse effects but there is an on-going requirement, consider using an alternative medication with a less harmful adverse effect profile for this specific person. Tapering, cross-tapering or direct switch strategies can be considered. Cross-tapering may minimise discontinuation effects when switching SSRIs (Selective Serotonin Reuptake Inhibitors) or psychotropics, with appropriate risk-benefit assessment of this approach.  

Plan to make one medication change at a time rather than all changes at once. Medications can be reduced or ceased at planned intervals to better assess the effect of each medication change.

Psychotropic Medicines in Cognitive Disability or Impairment Clinical Care Standard provides guidance and further information on monitoring, reviewing and ceasing psychotropic medications.