Deprescribing: Insights From an ASCP Panel of Psychiatric Experts

Joseph F. Goldberg, MD, in this special installment of "Brain Trust: Conversations in Psychopharmacology," sat down with a panel of experts from the American Society of Clinical Psychopharmacology Annual Meeting (ASCP) Deprescribing Task Force while in attendance at the 2026 ASCP Annual Meeting in Miami, FL. 

In the wake of the MAHA Institute summit on mental health on May 4, 2026, and the plans to curb “psychiatric overprescribing,” the ASCP released deprescribing recommendations for psychiatrists and practicing mental health clinicians.

Goldberg has been very passionate in speaking about proper and appropriate deprescribing, as evidenced by his May 2025 cover for Psychiatric Times: “Deprescribing: Does the Term Belong in the Psychiatric Lexicon?”

In this discussion, the panel explained the importance of deprescribing in the national dialogue and debate, and emphasized the need for judicious, thoughtful, supervised, purposeful, intentional, clinically-indicated decision making by clinicians.

David W. Goodman, MD, highlighted the lack of understanding among a broad range of prescribers with varying degrees of training and background, leading to inaccurate diagnoses and inappropriate prescriptions. 

Roger S. McIntyre, MD, FRCPC, emphasized the supply and demand mismatch in mental health services, noting the explosion in demand and the lack of quality healthcare supply. 

Rajnish Mago, MD, added that the difficulty in deprescribing is due to the complexity of managing multiple medications and the reluctance of patients, families, and doctors to change treatments.

Anita Clayton, MD, pointed out that most psychiatric medications are prescribed by primary care providers who lack the opportunity to follow patients closely and adjust medications as needed.

Leslie L. Citrome, MD, MPH, discussed the challenges of deprescribing in primary care settings, where time limitations and lack of measurement-based care hinder effective treatment.

Holly A. Swartz, MD, emphasized the importance of patient-clinician communication and the need for alternatives to medications, such as psychotherapy and lifestyle changes.

Mauricio Tohen, MD, suggested that the FDA should require tapering studies for new drugs to ensure appropriate deprescribing practices.

Swartz and Citrome highlighted the importance of screening tools and systematic reassessment in deprescribing.

Collectively, the group discussed practical approaches to deprescribing, including starting discussions with patients and prioritizing medications based on their impact.