Deprescribing is the systematic process of identifying and discontinuing drugs in instances in which existing or potential harms outweigh existing or potential benefits within the context of an individual patient’s care goals, current level of functioning, life expectancy, values and preferences.

Scope in Pediatrics

  • Among all children aged 6–17 years, 7.5% used psychotropic medication during the past 6 months.

  • Use of antipsychotic medications is amongst the fastest growing class of psychiatric medications. Use in Medicaid-enrolled Children age 3-18 grew 62% between 2002 and 2007. Evidence to support this increase for most conditions remains limited.

Teaching Points

  • Deprescribing is part of the good prescribing continuum, which spans initiation, dose titration, changing or adding drugs, and switching or ceasing drug therapies.

  • Deprescribing is not about denying effective treatment to eligible patients. It is a positive, patient-centered intervention, with inherent uncertainties, and requires shared decision making, informed patient consent, and close monitoring of effects-the same good prescribing principles that apply when drug therapy is initiated.

  • Deprescribing considers not only the risk associated with individual drugs but also the cumulative risk from multiple drugs due to pharmacokinetic and pharmacodynamic interactions. (Scott et. al. 2015)

  • Deprescribing, like prescribing, starts with a comprehensive psychiatric assessment. This is especially important when a youth is entering the clinician’s care already on medications.

  • The diagnosis and knowledge of the course of the disorder should inform the decision of whether and when to taper or discontinue a medication.

  • Once the youth is discontinued from those prescribed psychotropic medications which are able to be tapered, the clinician should remain available to the family as needed for support should resumption or intensification of symptoms occur.


For Physicians

Scott, IA et. al. Reducing Inappropriate Polypharmacy: the Process of Deprescribing. JAMA Internal Medicine 2015; 175(5); 827-34.

Howie LD, Pastor PN, Lukacs SL. Use of medication prescribed for emotional or behavioral difficulties among children aged 6–17 years in the United States, 2011–2012. NCHS data brief, no 148. Hyattsville, MD: National Center for Health Statistics. 2014.

National trends in the office-based treatment of children, adolescents, and adults with antipsychotics. Olfson M, Blanco C, Liu S-M, et. al. Archives of General Psychiatry 2012; 69, 1247-1256.

Rubin DM, Matone H, Huang Y-S, dosReis S, Feudtner C, Localio R. Interstate variation in trends of psychotropic medication use among Medicaid-enrolled children in foster care. Children and Youth Serv Rev. 2012;34(8):1492-1499.

Kreider AR, Matone M, Bellonci C, dosReis S, Feudtner C, Huang Y-S, Rubin DM. Growth in the Concurrent Use of Antipsychotics With Other Psychotropic Medications in Medicaid-Enrolled Children. Journal of the American Academy of Child & Adolescent Psychiatry; 2014, 53 (9).

Related AAP Policy

Children Exposed to Maltreatment: Assessment and the Role of Psychotropic Medication

Related AAP Resources

Antipsychotic Treatment Among Youth in Foster Care
How to deprescribe psychotropic drugs in children who have been maltreated


For COVID related questions, please email
For Mental Health related questions, please email
Brought to you by AAP Education. For more educational content visit

Special Acknowledgment

The AAP gratefully acknowledges support for the Pediatric Mental Health Minute in the form of an educational grant from SOBI.