What is deprescribing?

Deprescribing is the planned, supervised process of safely reducing or stopping medicines that are potentially inappropriate or no longer needed. The National Institute on Aging says researchers are studying it because taking many medications raises the risk of side effects and other unintended problems. It is done with a doctor, never alone: NIA advises not to stop any prescription medicine until the doctor says it is all right.

Deprescribing in dementia means reviewing a person's medicines and, with their doctor, reducing those that may now cause more harm than good. A 2023 study in Age and Ageing found that people with cognitive impairment commonly take multiple medications, including potentially inappropriate ones. In that study about 78.5 percent of older adults with dementia or mild cognitive impairment said they would be willing to stop a medication if their doctor said it was possible.

Yes, under a doctor's guidance. A Canadian evidence-based guideline published in Canadian Family Physician recommends deprescribing antipsychotics for adults with behavioral and psychological symptoms of dementia who have been treated for at least three months, either because symptoms have stabilized or because there was no response. The guideline comes with a decision-support tool for clinicians. Families should raise the question with the prescriber rather than stopping a medicine themselves.

Older adults take more medicines than any other age group, the National Institute on Aging says, often because they have several health problems at once. Taking many medicines, called polypharmacy, raises the risk of side effects and drug interactions, and medicines can work differently as the body ages. NIA suggests asking the health care provider whether any medicines could safely be reduced or stopped.

Fewer medicine-related harms is the main aim, and the evidence on survival is mixed. A 2016 systematic review in the British Journal of Clinical Pharmacology found that deprescribing for older adults lowered mortality in nonrandomized studies but not in randomized studies overall. Deaths did fall significantly when deprescribing plans were tailored to the individual patient. Any change to a medicine should be made with the person's doctor.