psychopharm references

[MApsychCNS]

Hello. I have lots of psychopharm books including THE PRESCRIBERS GUIDE by S. Stahl. What I really need is a reference that describes how best to taper pts off psychiatric meds. As a new CNS this is a concern for me since I have been unable to find the answer to this anywhere. I feel like I have been tapering too slowly on drugs that could be tapered faster or stopped all together. Online resources are great! Books too.

Any help?

[FluffyNipper]

I've seen little in the way of written instructions about how to taper one med and then how to start another. When you taper a patient from a given medication you consider many factors including such things as (a) the half life of the medication, (b) how the pt is tolerating the taper, © whether or not you are replacing it with a similar medication, (d) whether both medications are sedating (vs. is one sedating and is one sedating),

(e) the extent to which the pt is tolerating the med to be discontinued, (f) the urgency of getting the first med stopped vs. the urgency of getting the second med started, (g) DON'T FALL INTO THE TRAP OF THINKING THAT ONE MED MUST BE DISCONTINUED BEFORE YOU START THE SECOND MED IS STARTED. (h) incidentally, pts regularly will misunderstand your instructions and think they are to d/c one med before they start the second med. Remember, you won't know for weeks-to-months if a change of medication is helpful........

[Whispera, MSN, RN]

I haven't prescribed for awhile, but if memory serves, Stahl's book has information on how to taper. I know I used that book as my "bible" and did taper while starting patients on new meds. Check in the parts of the book that talk about the individual meds you want to taper.