Deprescribing requires some effort. I’ve noted a few recent discontinuations and deprescribing opportunities where things have gone right. I’d like to share those examples with you, and hopefully you can use these ideas in your practice.
- Melatonin Discontinued After Trazodone Is Started
If trazodone is added at bedtime and is providing adequate benefit for sleep, there is often little reason to continue scheduled melatonin. While melatonin is generally safe, every unnecessary medication adds complexity. Eliminating duplicate sleep aids is a simple win for patients and caregivers.
- Proton Pump Inhibitors Are Reviewed and Successfully Discontinued
PPIs are excellent medications when appropriately indicated, but many patients remain on them indefinitely without reassessment. Seeing a medication review that asks, “Does this patient still need a PPI?” is always encouraging. If symptoms have resolved and there is no ongoing indication, deprescribing can reduce long-term risks, medication burden, and cost.
- Seroquel Is Stopped After Hospital-Associated Delirium Resolves
Quetiapine is frequently started during a hospitalization for short-term delirium or agitation. Unfortunately, it sometimes follows patients into long-term care or outpatient practice without anyone questioning whether it is still necessary. Seeing Seroquel discontinued after delirium has resolved is a great example of thoughtful medication reconciliation.
- Iron Is Discontinued Three Months After Surgery When Hemoglobin Has Normalized
Postoperative iron supplementation is common after blood loss anemia. However, once hemoglobin has recovered and iron replacement has served its purpose, continuing therapy indefinitely rarely provides additional benefit. Stopping iron at the appropriate time reduces constipation, pill burden, and unnecessary medication use.
- Allergy Medications Are Reduced After a Viral Respiratory Infection
It is not unusual for patients to receive antihistamines or other allergy medications during or shortly after a viral upper respiratory infection because lingering congestion can resemble allergic symptoms. Once the infection resolves, these medications deserve another look. If symptoms have disappeared, discontinuing unnecessary allergy medications can reduce sedation, dry mouth, and fall risk—particularly in older adults.
The common theme across all five examples is simple: every medication should have a current indication. Regular medication review and identifying deprescribing opportunities are among the most valuable interventions pharmacists and prescribers can perform. Sometimes the best prescription is knowing when to stop one.
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