JCU first to teach safe deprescribing of psychiatric medications

James Cook University’s College of Medicine undergraduate and postgraduate medical degrees have become the first in Australia to teach doctors how to help patients who want to safely reduce or stop taking antidepressants and other psychotropic medications.

Associate Professor Carlo Longhitano, Head of Psychiatry at JCU, and Dr Sam Manger, GP and Senior Lecturer at JCU, have led this change  by integrating deprescribing in the mental health teaching curriculum of future doctors graduating from JCU and postgraduate health professionals trained in lifestyle medicine.

“Psychological issues are the most common reason for a patient visit to the GP, increasing from 61% in 2017 to 72% in 2023 according to the RACGP’s General Practice: Health of the Nation report,” said A/Prof Longhitano.

“Around 45 million mental health-related medications were dispensed in 2022–23, with 85% prescribed by GPs. Antidepressants are helpful and effective for many people, but they are not generally advised for use longer than 6–12 months and can come with serious side effects,” said Dr Manger.

He said Australia has the second highest antidepressant use per capita amongst OECD countries.

“Some Australians on antidepressants have trouble stopping their use due to severe withdrawal effects that can sometimes be incorrectly put down to relapse of their mental health condition. This is something we urgently need more medical student, GPs and psychiatry trainees educated to help people safely and comfortably reduce their medication use when indicated,” said Dr Manger.

Dr Longhitano said coming off antidepressants can be very difficult for some patients, especially if they had been on them for a longer period.

“Sadly, this component of teaching is currently missing from the medical school curriculum and from postgraduate training in psychiatry. I have recently added this component here at JCU’s medical school and am currently talking to the other Mental Health Education Leads in Australia and New Zealand to ensure this will no longer be the case across our countries.

“I am also ensuring locally trained psychiatrists are aware of this subject, leading to better cooperation between specialists and generalist doctors”.

The teaching will use the Maudsley Deprescribing Guidelines - a recognised evidence-based clinical resource on safe deprescribing in combination with lectures from leaders in the field.

The lead author is Australian doctor Mark Horowitz. His PhD at King’s College London was in the neurobiology of depression and the pharmacology of antidepressants and he knows firsthand the dangers of antidepressant withdrawal after he personally experienced severe side effects.

The JCU’s Bachelor of Medicine and Surgery (MBBS) program runs for 6 years, with 3 years preclinical teaching and 2 years of clinical subjects, followed by a year of elective internships and ‘hands on’ medicine across the JCU campuses in Cairns, Townsville and Mackay.

Fresh intakes occur in December every year via a competitive interview.

The JCU Lifestyle Medicine postgraduate degrees, Graduate Certificate, Graduate Diploma, Master and PhD pathways open in February and in July in 2025 and can be accessed via this link.