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De-prescribing & Hyperbolic Tapering
A careful, science-informed approach to safely reducing or coming off psychiatric medications. For people who feel ready to try — and who want to do it right.
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Who this is for
- People who feel stable and want to try reducing or coming off a psychiatric medication
- Those who have experienced difficult discontinuation symptoms with prior attempts
- Anyone who feels their current medication load is more than their current life requires
- People interested in a thoughtful, monitored approach rather than stopping abruptly
- Those who want a clinician who takes the discontinuation literature seriously
What careful tapering looks like
We start with a thorough assessment. What medication, what dose, how long, what your history looked like before starting — and what your life looks like now. That history shapes what a reasonable taper would look like.
Hyperbolic tapering protocols use small, graduated reductions that track with the brain’s receptor binding curves rather than arbitrary percentage steps. For some people, this means very small dose reductions at the low end — doses that require compounding pharmacy support.
We monitor closely, adjust frequently, and don’t rush. If something comes up during the taper — symptoms returning, discontinuation effects — we adjust. The goal is to come off in a way that holds.
“Wanting to come off medication isn’t anti-psychiatry. It’s a legitimate clinical goal that deserves a legitimate clinical approach.”
Sasha Bergeron, PMHNP-BC
Questions
All FAQ →Hyperbolic tapering is a method of reducing psychiatric medication that follows the brain's receptor occupancy curve rather than reducing by equal amounts. Because the relationship between dose and receptor binding is non-linear, small reductions at low doses can have a larger neurological impact than the same reduction at higher doses. Hyperbolic tapering accounts for this, typically using smaller and smaller absolute reductions as the dose decreases.
It depends on the medication, how long you've been on it, the dose, and how your system responds. Some tapers take months. Some take longer. The right pace is the one that allows your nervous system to adjust without destabilization. I don't rush this.
We adjust. A taper that isn't going well is information, not failure. We can slow the pace, hold at a dose for longer, or explore what support might make the process more manageable. The goal is a sustainable reduction, not a fast one.
Not necessarily. There are people for whom long-term medication is the right choice, and coming off it would carry meaningful risk. Part of the work is making that assessment honestly — not defaulting to 'you should come off' any more than defaulting to 'you should stay on.' I try to be clear-eyed about both sides.