Book review: The Maudsley Deprescribing Guidelines

Marion Brown

doi:10.3399/bjgp24X739209

Published eLetters

eLetter submission guidelines

Submit a Response to This Article

Compose eLetter

Title *

Author Information

Contributors

First Name and Middle Initial *

First or given name, e.g. 'Peter'.

Last Name *

Your last, or family, name, e.g. 'MacMoody'.

Email Address *

Your email address, e.g. higgs-boson@gmail.com. PLEASE NOTE: your email address will be published.

Occupation *

Your role and/or occupation, e.g. 'Orthopedic Surgeon'.

Affiliation *

Your organization or institution (if applicable), e.g. 'Royal Free Hospital'.

Statement of Competing Interests

Competing interests? *

Yes

Please describe the competing interests

CAPTCHA

This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.

Vertical Tabs

Jump to comment:

Book review: Maudsley Deprescribing Guidelines
Marion Brown

Published on: 05 September 2024
The Maudsley Deprescribing Guidelines
Judith Neaves

Published on: 02 September 2024

Published on: (5 September 2024)
Page navigation anchor for Book review: Maudsley Deprescribing Guidelines
Book review: Maudsley Deprescribing Guidelines
Marion Brown, Retired, none
I thank Dr Judith Neaves for her e-letter response¹ to my letter² regarding the book review by Dr Sian Gordon of ‘The Maudsley Deprescribing Guidelines’ – book by Mark Horowitz and David Taylor.

The points are valid. This is a pricey formal medical book. It contains a wide-ranging and important introduction to the topic of Deprescribing followed by detailed information about four major commonly GP-prescribed drug classes (antidepressants, benzodiazepines, gabapentinoids and Z-drugs) - and then is further broken down into the many specific drugs within each of the broad classes - which drugs each have their own individual characteristics. The authors have purposely structured the book in this way so that busy prescribers can look up specific drugs easily - and the set of essential overarching deprescribing principles are repeated in the segment for each drug (over 45 drugs). This adds to the size of the book (due to inevitable repetition) but is designed so that the essential important deprescribing principles are not overlooked ‘in haste’.

For these reasons ‘a summary’ for GPs is not appropriate. There really are no shortcuts. In Dr Neaves’ own role as an NHS GP educator who likes to ‘agree a way forward with patients’,³ perhaps she may help to develop essential UK GP education on this topic? Up until now this has been sorely lacking, and GPs and patients left...
Show More

I thank Dr Judith Neaves for her e-letter response¹ to my letter² regarding the book review by Dr Sian Gordon of ‘The Maudsley Deprescribing Guidelines’ – book by Mark Horowitz and David Taylor.

The points are valid. This is a pricey formal medical book. It contains a wide-ranging and important introduction to the topic of Deprescribing followed by detailed information about four major commonly GP-prescribed drug classes (antidepressants, benzodiazepines, gabapentinoids and Z-drugs) - and then is further broken down into the many specific drugs within each of the broad classes - which drugs each have their own individual characteristics. The authors have purposely structured the book in this way so that busy prescribers can look up specific drugs easily - and the set of essential overarching deprescribing principles are repeated in the segment for each drug (over 45 drugs). This adds to the size of the book (due to inevitable repetition) but is designed so that the essential important deprescribing principles are not overlooked ‘in haste’.

For these reasons ‘a summary’ for GPs is not appropriate. There really are no shortcuts. In Dr Neaves’ own role as an NHS GP educator who likes to ‘agree a way forward with patients’,³ perhaps she may help to develop essential UK GP education on this topic? Up until now this has been sorely lacking, and GPs and patients left struggling with unexpected and unintended consequences.

BJGP Life did publish online in 2022 an introductory article ‘Antidepressant withdrawal syndrome and its management’ – BJGP Life,⁴ including a one-hour training video ENGLISH Antidepressant Withdrawal Syndrome and its Management (youtube.com)⁵ by Mark Horowitz (Co-author of the Maudsley Deprescribing Guide) and Stevie Lewis, and a further article in 2023 How to help patients safely taper and withdraw from antidepressants – BJGP Life.⁶

It is hoped that this Maudsley Deprescribing publication may soon be made freely available to those working in the NHS. Meanwhile patients are finding the information within the book invaluable and have been giving copies to their own GPs - with the aim of working together with their prescribers to proactively manage their own withdrawal from these drugs.

References

1. Neaves J. eLetter. The Maudsley Deprescribing Guidelines. Br J Gen Pract 2024. https://bjgp.org/content/74/746/397.2/tab-e-letters

2. Brown M. Book review: The Maudsley Deprescribing Guidelines. Br J Gen Pract 2024; 74 (746): 397-398.

3. NHS England. Dr Judith Neaves. https://medical.hee.nhs.uk/medical-training-recruitment/medical-specialty-training/general-practice-gp/choose-gp/choose-gp-career-stories/dr-judith-neaves.

4. Lewis S, Horowitz M. Antidepressant withdrawal syndrome and its management. BJGP Life 2022. www.bjgplife.com/antidepressant-withdrawal-syndrome-and-its-management/

5. ENGLISH Antidepressant Withdrawal Syndrome and its Management, www.youtube.com/watch?v=PSjYH044-2Q.

6. Lewis S, Horowitz M. How to help patients safely taper and withdraw from antidepressants. BJGP Life 2023. www.bjgplife.com/how-to-safely-taper-and-withdraw-from-antidepressants/.

Show Less

Competing Interests: None declared.
Published on: (2 September 2024)
Page navigation anchor for The Maudsley Deprescribing Guidelines
The Maudsley Deprescribing Guidelines
Judith Neaves, GP, none
Thank you Marion for the review. Unfortunately a text as extensive as this with a price tag of around £44 is not going to be used by the vast majority of GPs, only suitable for more specialist clinicians. I hope a summary might become available.

Competing Interests: None declared.