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What deprescribing is
Deprescribing is the planned, supervised process of reducing or stopping a medication that may no longer be needed — or may be causing more trouble than it's worth.
It is not about being "anti-medication." Medications can be genuinely useful, and I use them frequently in my practice. But staying on a medication should be a decision, not a default. If you and I agree that coming off makes sense, you deserve a process as thoughtful as the one that started it.
Why the hyperbolic method?
Most psychiatric medications don't act on the brain in a straight line. The relationship between the dose you take and the effect at the receptor is curved — what pharmacologists call hyperbolic.
A standard taper usually cuts the dose by the same amount each step — say, 10 mg, then 10 mg, then 10 mg. The problem is that near the lower doses, each equal-sized cut produces a much larger drop in actual effect on the brain. That's often exactly when withdrawal symptoms hit hardest, and why so many people get stuck or give up. In other words, a standard taper sometimes causes uncomfortable symptoms, especially as the dose gets lower.
A hyperbolic taper accounts for the curve. Reductions are proportional, and they get progressively smaller as the dose gets lower — so the change your brain has to absorb stays roughly even from one step to the next. In practice, this often means using liquid formulations or small, custom doses to make those final, gentle steps possible.
It is slower. It is also far more comfortable, and far more likely to work and to sustain results, even when you’re no longer taking the medication.
Who this is for
This may be a good fit if:
You've been on a psychiatric medication for a long time and want to know whether you still need it.
You've tried to come off before and the withdrawal was worse than you expected.
You're doing well and would like to find your lowest effective dose — or no dose at all.
A medication is causing side effects that are no longer worth the trade-off.
You want a clinician who will go at your pace and not rush you.
You're tapering an SSRI, SNRI, benzodiazepine, antipsychotic, gabapentinoid, or other long-term psychiatric medication and want it done carefully.
What the process looks like
A typical deprescribing trajectory includes:
An initial consultation to review your current regimen, your reasons for considering a taper, what you've tried before, and your goals.
A detailed medication history — what worked, what didn't, what side effects you've experienced, and any previous attempts to come off.
A custom taper plan built around the hyperbolic curve, with proportional dose reductions and a realistic timeline. We'll often use liquid formulations or compounded preparations to make the smaller steps possible.
Structured check-ins to monitor how you're tolerating each step, and to slow down, pause, or hold doses when needed.
Coordination with your original prescriber whenever possible, so the people responsible for your care stay aligned.
Distinguishing withdrawal from a true return of symptoms — they're not the same, and confusing them is one of the most common reasons tapers fail.
What this is — and isn't
This is a collaboration. You set the pace; you can slow down, pause, or hold a dose for as long as you need. The goal is to come off safely and comfortably, not quickly.
One important thing: please don't stop a psychiatric medication on your own. Stopping abruptly can be uncomfortable and, with some medications, genuinely risky. The whole point of this work is to do it safely, with support.
Related services
Psychiatric medication management — for ongoing prescribing, dose adjustments, and integrative care.
Comprehensive autism evaluations — when deprescribing is part of a broader picture.
Leucovorin for autism — for carefully selected patients with autism and folate-related findings.
Common questions
Do I have to stop my medication completely? No. The goal can be your lowest effective dose rather than zero. We decide together, based on how you're doing.
Will you work with my current prescriber? Yes, whenever possible. Keeping your prescriber in the loop makes the process safer and smoother — it also means you don't have to choose between us.
How long does a taper take? It depends — on the medication, the dose, how long you've taken it, and how your body responds. Hyperbolic tapers are intentionally slow, often unfolding over many months. You set the pace.
Which medications can you help me come off? Most long-term psychiatric medications — including SSRIs and SNRIs, benzodiazepines, antipsychotics, gabapentinoids, and others. We'll talk through your specific medication during the consultation.
What if I start the taper and decide to stop? That's allowed. We can hold at any dose, return to your previous dose, or pause indefinitely. Tapering is a process, not a contract.
Do you take insurance? The practice is fee-for-service, with a reduced session rate for deprescribing care given its long-term nature. A superbill can be provided for possible out-of-network reimbursement, and HSA cards are accepted. We'll talk through cost during the consultation.
Ready to talk?
I offer a free 15-minute consultation call to talk through your medication, your goals, and whether a hyperbolic taper is right for you.