SynthesisBasic & clinical pharmacology & toxicology2026
Deprescription of Psychotropics in Children and Adolescents: Systematic Review of Guidelines and Development of a Deprescribing Algorithm.
Synthesis in Basic & clinical pharmacology & toxicology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Authors and funding
7 authors.
Funding
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Abstract
backgroundPsychotropics are increasingly prescribed in paediatrics despite limited evidence regarding their benefits and effectiveness. Although deprescribing approaches are established in adults, structured paediatric strategies remain poorly defined.
aimsTo identify and evaluate clinical practice guidelines (CPGs) on psychotropic deprescribing in youth, to describe and discuss recommendations regarding when and how to deprescribe in practice.
methodsWe systematically searched PubMed, Embase, PsycInfo, Scopus, Web of Science and grey literature (2015-2025). Two reviewers independently screened and evaluated the quality of the guidelines (AGREE II). We derived from this a psychotropic deprescribing algorithm in youth, supplemented with clinical expertise.
resultsAmong the 1390 records identified, none strictly met the methodological criteria for formal CPGs. Nevertheless, we assessed two papers that provided practical deprescribing recommendations and shared several characteristics with CPGs. One systematic review focused on antidepressant discontinuation, recommending tapering after remission with gradual dose reduction and monitoring to distinguish withdrawal from relapse. One narrative review provided child-specific guidance for stimulants, recommending reassessment and possible discontinuation after 1 year of stability. Both were rated as 'moderate' using the AGREE II tool and provided limited practical detail on stepwise deprescribing procedures.
conclusionCritical gap and urgent need for paediatric-specific deprescribing guidelines. We propose an expert-informed stepwise deprescribing algorithm.
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