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Implementing psychiatric drug withdrawal practices: challenges with individuals with multiple comorbid behavioral and health problems

Journal of Psychology & Clinical Psychiatry
Marcello Maviglia,1 Norman J Cooeyate2


Treating dually diagnosed individuals with psychiatric medications is very complex as they present often with physical comorbidities and social challenges. Although the need to explore titration and withdrawal from psychiatric medications continues to be raised by consumers, professionals, researchers, and advocacy groups, such a possibility is rarely addressed in clinical practice, since it is extremely challenging and necessitates a nuanced understanding of the interplay of multiple factors (psychological, physical, social). In the article, the authors address the difficulties related to prescribing psychiatric medications and explore the possibility of withdrawal strategies, particularly for dually diagnosed clients. In this frame, they illustrate the development of a withdrawal in a clinic in the southwestern region of the US, which could potentially be considered a beginning of a model to be developed further. Also, the authors are trying to raise awareness regarding the perils of prescribing for dually diagnosed patients, without clear therapeutic objectives and goals, and the possibility of offering withdrawal paths to those individuals who could benefit from it. Moreover, they highlight the importance of peer support- recovery-based interventions, and cultural sensitivity as essential aspects of psychiatric drug prescribing practices.


psychiatric drug withdrawal, dual diagnoses, peer specialists, culture and health, indigenous health