Appropriate prescribing toolkit: How to stop medicines
This page forms part of the Appropriate prescribing toolkit. Use the links in the left hand menu to return to the main toolkit page or access the additional sections.
1. General guidance
bpacnz. 2018. Stopping medicines in older people: the flip side of the prescribing equation. URL: https://bpac.org.nz/2018/stopping.aspx | Download a copy (806 KB, pdf)
bpacnz. 2010. A Practical Guide to Stopping Medicines in Older People. Best Practice Journal 27. URL: https://bpac.org.nz/BPJ/2010/April/stopguide.aspx | Download a copy (341 KB, pdf)
2. Specific medicines
Taper MD: Provides resources to guide the deprescribing process for specific medicines, including guidelines, algorithms and patient handouts. URL: https://tapermd.com/taper-guide/.
3. General and specific guidance
Consultant Pharmacy Services (CPS) deprescribing resources: Provides a reference guide, general deprescribing information and a detailed fact sheet for deprescribing 14 medicines/medicine groups. URL: http://www.cpsedu.com.au/courses/take/47.
4. Proton pump inhibitors (PPIs)
Stopping proton pump inhibitors in older people
bpacnz. 2019. Stopping proton pump inhibitors in older people. Best Practice Journal. URL: https://bpac.org.nz/2019/docs/ppi.pdf | Download a copy (978 KB, pdf)
5. Mental health medicine
Matua Raki. 2017. A guide to reducing or stopping mental health medication – notes for prescribers. URL: https://bit.ly/3cTAzJX | Download a copy (292 KB, pdf)
These notes are written to augment the information for consumers in A guide to reducing or stopping mental health medication. They are intended for any prescribers helping someone stop their mental health medication, but it is anticipated they will be most useful for general practitioners.
6. Cholinesterase inhibitors and memantine
Reeve E, Farrell B, Thompson W, et al. 2019. Deprescribing cholinesterase inhibitors and memantine in dementia: guideline summary. Medical Journal of Australia 210(4): 174-9. URL: https://doi.org/10.5694/mja2.50015 | Download a copy (742 KB, pdf)
These evidence-based guidelines provide practical recommendations for when to deprescribe, or withdraw patients from therapy with medicines used to alter the progression of dementia – cholinesterase inhibitors and memantine. The recommendations include when to consider deprescribing, and advice on how to taper withdrawal to avoid potentially severe adverse drug reactions related to treatment discontinuation. Tips for recognising the symptoms of withdrawal are provided.
These guidelines complement the Clinical practice guidelines and principles of care for people with dementia which provide recommendations for the non-pharmacological management for the behavioural and psychological symptoms of dementia. The guidelines and a consumer companion guide are available at: https://sydney.edu.au/medicine/cdpc/resources/dementia-guidelines.php.