What medications should be considered for review as part of a gradual dose reduction program?



Gradual dose reduction (GDR) is a method used to reduce the dosage of a specific medication while closely monitoring the resident’s progress and potentially incorporating alternative intervention strategies. Phase 2 of the Requirements of Participation (ROPs), which was released in November 2017, expanded the guidelines for GDR by including additional categories of psychotropic drugs, rather than focusing solely on antipsychotics. This change was prompted by concerns that reducing antipsychotic medications might lead to an increase in other medications that could impact brain activity. The  following classes of medications should be considered for review as part of a GDR program:  Benzodiazepines, Antipsychotics, Antidepressants, and Sedative-hypnotics. It’s worth noting that if a medication is prescribed to treat symptoms consistent with psychotropic medications, it may also fall under the same guidelines for review and potential gradual dose reduction.


Nancy Casperd, BSN, RN, CHC
Clinical Consultant

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