Deprescribing: A Psychodynamically-Informed, Patient-Centered Perspective

Background: Medications can have a wide range of symbolically mediated effects on patients and these effects can be positive or negative. When medications serve conflicting counter-therapeutic goals, action, including deprescribing, may be needed to ameliorate them. Method: Drawing on work with complex, treatment-refractory patients, we have identified strategies to inform and guide practitioners encountering meaning-based counter-therapeutic medication effects. Conclusion: These include the development of an overall diagnosis, a focus on the therapeutic alliance, addressing pathogenic meanings of medications and approaching deprescribing as an interpersonal process.