You, you've obviously spent a career, uh, looking at pharmacokinetic interactions, and I, I wonder if we sometimes get a little lazy and don't consider the pharmacokinetic interaction.

Absolutely.

And I, I think, you know, you bring up pharmacokinetics, but I would also bring up pharmacodynamics and, and again, I keep coming back to also the psychological factors that drive this.

But when we really start to think about how to safely and effectively taper these medications, we really need to think about all three.

We need to think about the pharmacokinetics, and again, it's not just about half-life.

Uh, we need to consider the pharmacodynamics and the individual receptor pharmacology.

Uh, and then we need to, again, consider some of those psychological factors in terms of the patient's expectations, uh, which are important, as Dr. Stahl and I have recently talked about, in terms of a lot of controversies, uh, that, uh, tend to accompany these deprescribing, uh, discussions.

But then I think, Jeff, uh, is this time, should we tackle the, uh, five or ten percent patients that you may see that discontinue medicines that will come in and be a part of this group that, uh, believes that they have been done a j- mis- mi- uh, uh, uh, misjus- justice by being on the medicines in the first place and that they were never sick in the first place and now that they're addicted to the medicines and it'll take, uh, two percent withdrawal per month over four years in order to get off of it Um, you know, I'm kind of mocking it a little bit, but you can tell how I feel about it, but the, the reality is you who are listening in here may actually have some people that, that, that have that and, and if maybe we should give them some guidelines of how you would handle that.

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Stay tuned for thoughtful and informative responses from our expert faculty.

Hello and welcome.

My name is Dr. Jeffrey Strachan, and I'll be answering your questions about my presentation, From Avoidance to Action: Evidence-Based Pathways to Recovery for Difficult to Treat Anxiety.