What is Deprescribing?

Deprescribing is the planned, supervised process of lowering the dose of a medication or stopping it altogether. It’s not about being “for” or “against” medication. It’s about making sure every medication your child takes is still doing meaningful work, at the lowest effective dose, with benefits that clearly outweigh the downsides.

For young people, this kind of periodic review is especially important. Medications are often started during a crisis or a particularly hard period, and once things stabilize, no one may stop to ask whether they’re still necessary. Over time, some children end up on several medications, sometimes added by different prescribers, without a clear sense of what each one is doing.

When Families Consider Deprescribing

Families come to me with questions about reducing or stopping medication for many reasons, including:

• Your child has been doing well for a long time, and you wonder if they still need medication

• A medication was started years ago, when your child was much younger

• Your child is taking multiple medications and it’s unclear which ones are helping

• Side effects such as appetite changes, weight gain, sleep problems, fatigue, or feeling “flat” are getting in the way

• A medication was prescribed for a specific problem or period that has since passed

• Your teen wants to understand who they are without medication, or to have more say in their own care

• You’d like a second opinion on your child’s current medication plan

Why a Careful Approach Matters

Stopping a psychiatric medication is a medical decision, and how it’s done matters as much as whether it’s done. Some medications need to be tapered slowly to avoid uncomfortable withdrawal effects or physical rebound effects. Others can be stopped more simply, but it may take weeks to know whether symptoms will return. Without a plan, it can be hard to tell whether a child is experiencing a return of their original symptoms, a temporary discontinuation effect, or simply a rough week.

I strongly encourage families not to stop medications abruptly or on their own. A thoughtful plan helps protect your child’s progress and gives everyone a clearer picture of what the medication has been doing.

My Approach to Deprescribing

Comprehensive Medication Review: I’ll look closely at your child’s full medication history: why each medication was started, what was happening at the time, how your child responded, what side effects they’ve had, and how they’re doing now. Sometimes this review alone brings real clarity.

Re-Evaluating the Diagnosis: Diagnoses made in early childhood or during a crisis are worth revisiting. Understanding what’s driving your child’s difficulties today helps us decide which medications are still serving a purpose.

Thoughtful Timing: When we reduce a medication matters. I’ll help you choose a stable period, often avoiding exam weeks, major transitions, or the start of a new school year, so we can observe changes clearly and respond if needed. For many families, summer is a natural window.

One Change at a Time: When a child is on several medications, I generally adjust one at a time and go slowly, so we can understand the effect of each change.

Close Monitoring: During and after a taper, we’ll stay in close contact. I’ll help you and your child know what to watch for, and we’ll agree in advance on what would lead us to pause, slow down, or resume a medication. Deciding that a medication is still helpful is a perfectly good outcome.

Building Support Around Your Child: Reducing medication often goes best when other supports are in place, such as therapy, parent guidance, healthy sleep routines, and school accommodations. I’ll help make sure your child has what they need to stay well.

Including Your Child’s Voice: Children and especially teens deserve to understand their own treatment. I’ll involve your child in conversations about their medications in a way that fits their age, so they feel informed and respected in the process.

Collaboration with Other Providers: If your child sees another prescriber, pediatrician, or therapist, I can coordinate with them, with your permission, so that everyone is working from the same plan.

What to Expect

The intake for children and adolescents is completed in three parts:

Part 1: Parent Session (60 minutes)
We’ll meet without your child to talk through your concerns, your child’s developmental, medical, and school history, the full medication history, and your family’s goals.

Part 2: Child Session (60 minutes)
I’ll meet with your child or teen to get to know them directly: how they see things, how they feel about their medications, what feels hard, and what’s going well.

Part 3: Feedback Session (30 minutes)
About one week later, we’ll meet again to go over my impressions and talk through options together, including whether and how to begin reducing medication.

Between sessions, I’ll review any records you share, such as prior treatment records, pharmacy history, testing, or report cards, and, with your permission, speak with outside providers involved in your child’s care.

If we decide to move forward, I’ll create a written, step-by-step plan for any changes, with regular follow-up appointments to monitor how your child is doing along the way.

What to Expect

I work with children, adolescents, and their families in New York City who have questions about their child’s current medications. Whether your child is on one medication or several, has been stable for years or is struggling with side effects, I’m here to help you make a thoughtful, informed decision.

Getting Started

If you’ve been wondering whether your child still needs their medication, you don’t have to figure it out alone. A careful review can bring clarity, and when the time is right, a well-planned taper can help your child move forward with confidence.

Please don’t stop or change your child’s medication without guidance from a prescriber. If you have urgent concerns about a medication, contact your child’s prescribing clinician or pharmacist.