{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T05:39:09Z","timestamp":1792388349753,"version":"4.4.0"},"reference-count":40,"publisher":"SAGE Publications","issue":"10","license":[{"start":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T00:00:00Z","timestamp":1784592000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Child and Adolescent Psychopharmacology"],"published-print":{"date-parts":[[2026,12,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Deprescribing, a structured, planned, and supervised approach to medication discontinuation, is increasingly recognized as an imperative rather than an elective component of rational psychopharmacological practice. Deprescribing is particularly compelling in child and adolescent psychiatry, where, despite accumulating evidence for pharmacotherapy, uncertainties regarding long-term risks and benefits persist. This makes deprescribing an important and often complex clinical consideration. Despite growing international attention, deprescribing remains challenging to implement in routine clinical care and is relatively understudied, especially in low- and middle-income countries. This study examined clinicians\u2019 perspectives on perceived barriers and facilitators to deprescribing psychotropics in tertiary Child and Adolescent Mental Health Services in India.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>The Reflexive Thematic Analysis framework, proposed by Braun and Clarke, was followed. Fourteen child mental health practitioners were recruited through purposive sampling to ensure diverse representation of clinical experience and practice settings. The sample included six consultants, seven specialty trainees, and one general psychiatry resident. Data were collected through in-depth interviews. Data collection and analysis were conducted iteratively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Five interrelated themes were identified:\n                      <jats:italic toggle=\"yes\">Evolving clinical philosophy<\/jats:italic>\n                      ;\n                      <jats:italic toggle=\"yes\">Illness Trajectory, Clinical Risk, and the Timing of Deprescribing<\/jats:italic>\n                      ;\n                      <jats:italic toggle=\"yes\">Shared and Shifting Roles in Deprescribing Decision-Making; Health System Constraints and (lack of) Care Continuity;<\/jats:italic>\n                      and\n                      <jats:italic toggle=\"yes\">Cultural and Socioeconomic Context Shaping Deprescribing processes<\/jats:italic>\n                      . Together, these themes showed that deprescribing was viewed as a negotiated process influenced by clinician confidence, illness severity, caregiver readiness, adolescent agency, service limitations, and sociocultural pressures.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Deprescribing in child and adolescent psychiatry is an evolving clinical competency influenced by clinician, family, health-system, and cultural factors. Structured training, context-specific guidelines, active involvement of children and families, and improved service coordination can support safe deprescribing practices.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10445463261469316","type":"journal-article","created":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T06:46:12Z","timestamp":1784702772000},"page":"631-641","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Exploring Barriers and Facilitators to Deprescribing Psychotropics in Child and Adolescent Psychiatry: A Qualitative Study from India"],"prefix":"10.1177","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-2238-6000","authenticated-orcid":false,"given":"Kanika","family":"Sethi","sequence":"first","affiliation":[{"name":"Department of Child and Adolescent Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harshini","family":"Manohar","sequence":"additional","affiliation":[{"name":"Department of Child and Adolescent Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John Vijay Sagar","family":"Kommu","sequence":"additional","affiliation":[{"name":"Department of Child and Adolescent Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,7,21]]},"reference":[{"key":"e_1_3_1_2_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0151066"},{"key":"e_1_3_1_3_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40545-023-00671-9"},{"key":"e_1_3_1_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2014-006544"},{"key":"e_1_3_1_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaac.2019.07.154"},{"key":"e_1_3_1_6_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjqs-2019-010033"},{"key":"e_1_3_1_7_1","doi-asserted-by":"publisher","DOI":"10.1136\/ejhpharm-2016-000949"},{"key":"e_1_3_1_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaac.2016.07.577"},{"key":"e_1_3_1_9_1","doi-asserted-by":"publisher","DOI":"10.1089\/cap.2022.0010"},{"key":"e_1_3_1_10_1","doi-asserted-by":"publisher","DOI":"10.1191\/1478088706qp063oa"},{"key":"e_1_3_1_11_1","doi-asserted-by":"publisher","DOI":"10.1177\/070674370104600904"},{"key":"e_1_3_1_12_1","doi-asserted-by":"publisher","DOI":"10.1176\/foc.6.3.foc368"},{"key":"e_1_3_1_13_1","unstructured":"Deprescribing.org. (no date) Deprescribing guidelines and algorithms. Available from: https:\/\/deprescribing.org\/ [Last accessed: 28February 2026]."},{"key":"e_1_3_1_14_1","doi-asserted-by":"publisher","DOI":"10.4103\/psychiatry.IndianJPsychiatry_570_18"},{"key":"e_1_3_1_15_1","doi-asserted-by":"publisher","DOI":"10.4103\/psychiatry.IndianJPsychiatry_563_18"},{"key":"e_1_3_1_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/MJT.0000000000000552"},{"key":"e_1_3_1_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.apnr.2005.06.001"},{"key":"e_1_3_1_18_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.i2893"},{"key":"e_1_3_1_19_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.f150"},{"key":"e_1_3_1_20_1","doi-asserted-by":"publisher","DOI":"10.1080\/14740338.2023.2224557"},{"key":"e_1_3_1_21_1","first-page":"28","volume-title":"BMJ Quality & Safety","author":"Langford AV","year":"2025","unstructured":"Langford AV, , Warriach I, , McEvoy AM, et al. What do clinical practice guidelines say about deprescribing? A scoping review. BMJ Quality & Safety. 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