Medication discontinuation


Medication discontinuation is the ceasing of a medication treatment for a patient by either the clinician or the patient themself. When initiated by the clinician, it is known as deprescribing. Medication discontinuation is an important medical practice that may be motivated by a number of reasons:
Unlike the prescribing of medications, appropriate discontinuation has not attracted nearly as much attention or interest.

End-of-life care

Medications may be stopped in the context of end-of-life care, such as medications that may affect risk factors for future disease. Medications that may be stopped as part of discussions about end-of-life care include antihypertensives, medications for diabetes, and drugs for high cholesterol.

Life limiting conditions

For people with a life limiting condition such as a dementia, it is important to consider when to discontinue medications used to prevent future serious events. The Medication Appropriateness Tool for Comorbid Health conditions during Dementia provides guidance for clinicians and consumers on how to manage medications.

Effects

Drug discontinuation may cause rebound effects and withdrawal syndromes.
Drug discontinuation may be difficult to adjust to, owing to the long term use and the symbolism associated with ceasing medications, such as the decision to stop chemotherapy.
Recent research shows that General Practitioners who actively consider discontinuation, are reluctant to do so, as they experience that the safest decision is to continue prescriptions, rather than discontinue them. In part this is due to the ambiguity about the appropriateness of discontinuing medication. The clinical guidelines available to GPs do not encourage discontinuation of medication, and thus, they offer GPs a weak frame for discontinuation.