Psychiatric Deprescribing: Case Studies and Clinical Implications in Forensics

The use of psychiatric medications is highly individualized. Polypharmacy is common, often introducing additional risks with limited benefits. In correctional settings, judicious use of psychiatric medications is critically important. During transitions of care, such as admission to a correctional facility, individuals benefit from timely and evidence-based prescriptive practices. Various factors can impact the continuation of treatment and medication access for incarcerated individuals, including communication gaps between community clinicians and correctional medical teams, formulary options, structured medication administration schedules, substance misuse, feigned illness, and diversion. Forensic nurses and advanced practice nurses navigate these complexities to provide effective and safe medication plans for incarcerated individuals. Incarceration presents an opportunity to review and deprescribe medications that are excessively or inappropriately prescribed. The existing psychiatric deprescribing literature is limited, with even less evidence oriented towards forensic settings. This paper utilizes case studies of incarcerated individuals to explore clinical insights and experiences related to deprescribing.