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Deprescribing · Medication Review · Step-Down Plans

Your prescription list was written for who you were then. Is it still right for who you are now?

A doctor-led medication review that applies the same clinical reasoning used to start a drug — to decide whether to continue, reduce, or stop it.

Deprescribing is not simply stopping tablets. It is a structured review of indication, benefit, risk, alternatives, monitoring, and follow-up. Medication changes should always be coordinated with your usual doctor where appropriate.

Book a Medication Review — £395

Clinical appointments via CQC-registered Sutton Medical Consulting

Metabolic & Deprescribing Review
£395
60-minute review
  • Full medication list reviewed in advance
  • Clinical assessment of indication and risk
  • Personalised step-down plan where appropriate
  • Clear monitoring points and decision rules
  • Written plan to take away
  • GP coordination where appropriate
Book a Medication Review Or message on WhatsApp →

Follow-up support from £125

Most prescriptions are never reviewed after they are written.

People accumulate medications during stressful years — illness, weight gain, poor sleep, menopause, a difficult season — and then never get a clean reassessment once things improve.

The GP who added the medication has moved on. The specialist who initiated it discharged you. The repeat prescription just keeps printing.

This review exists for the patient who wants one doctor to look at the whole picture.

  • You have side effects you were told to tolerate — and you want a second opinion on whether they are necessary
  • Your health has improved significantly since a medication was started, but the prescription list hasn't changed
  • You are on multiple medications from multiple prescribers and no one has reviewed the full picture
  • You want to stop a medication — safely, with a proper plan — not abruptly
  • You are unsure whether a medication still makes clinical sense for your situation
  • You want one coherent, medically defensible view of what you are taking and why

The same clinical reasoning used to start a drug — applied again later.

Deprescribing is the careful reduction or stopping of medications that may no longer be helping — or may now be causing more harm than benefit.

It is not anti-medicine. It is medicine done properly.

When a medication is started, a clinical decision is made: the benefit outweighs the risk for this patient, now. That calculation changes over time. Weight changes. Blood pressure changes. Lifestyle changes. A medication started under one set of circumstances may no longer be indicated under different ones.

The review asks the same question that should have been asked at every repeat: is this still the right decision for this patient today?

"Sometimes the outcome is continue — with reassurance and a clear reason. Sometimes it is adjust, reduce, or stop — with a plan and monitoring. The decision is always personalised and safety-led."

— Dr Dan Reardon · NHS A&E Doctor · GMC 6098984

What is deprescribing?

Deprescribing is the planned, supervised reduction or stopping of medications that may no longer be appropriate. It is the clinical counterpart to prescribing — applying the same risk-benefit analysis that was used to start a drug, to decide whether it should continue.

Most medications are started during a specific clinical moment: a diagnosis, an acute episode, a period of poor health. The decision to start is usually well-reasoned. The problem is that the review rarely happens. Weight changes. Blood pressure normalises. The original indication resolves. The prescription continues on a repeat, unchanged, sometimes for years.

Deprescribing does not mean stopping everything. Often the outcome is to continue — with reassurance and a documented clinical reason. But when a medication's benefit no longer outweighs its risk, or when it has never been formally reviewed since it was started, the clinical duty is to question it.

In the UK, deprescribing is supported by NICE guidance, the King's Fund polypharmacy review, and NHS England's structured medication review framework. It is mainstream clinical practice — it is simply not available at the pace or depth that patients deserve in a standard GP appointment.

GLP-1 / Weight-Loss Injections SSRIs & Antidepressants PPIs & Reflux Medication Statins Blood Pressure Medication Levothyroxine Polypharmacy

Choose your starting point.

Each pathway has a different rebound pattern and taper strategy. Not sure which applies? A medication list review covers the full picture.

Flagship

GLP-1 Exit Strategy

Wegovy · Ozempic · Mounjaro

Exit planning, appetite rebound management, and long-term weight maintenance after GLP-1 treatment.

View pathway →

SSRI Review

Sertraline · Fluoxetine · Citalopram

Careful taper planning with stability scaffolding across sleep, stress load, and relapse prevention.

Book a review →

PPI Step-Down

Reflux medications

Rebound reflux planning, dietary trigger identification, and step-down strategies.

Book a review →

Statin Review

Where appropriate

Primary prevention decisions — benefits, trade-offs, risk stratification, and the clinical case for continuing or stopping.

Book a review →

Blood Pressure Step-Down

After weight loss or fitness gains

Step-down with home monitoring after meaningful lifestyle improvement. Safe, monitored, and responsive.

Book a review →

Levothyroxine Review

Do you really need it

Was the original indication clinically justified, is a question very few patients have ever been invited to ask.

View pathway →

Medication Load Review

Polypharmacy

On multiple medications? One coherent, clinician-led plan — mapping the full regimen, interactions, and priorities.

View pathway →

A structured clinical decision — not abrupt stopping.

Medication changes are individual. They require review, planning, monitoring, and follow-up. This is what that looks like.

01

Review the full picture

History, current medications, relevant results, side effects, and what has changed since the prescription was first written.

02

Assess indication and risk

Is the medication still indicated? What is the risk-benefit balance now? What does stopping, reducing, or continuing actually mean for you specifically?

03

Build the step-down plan

A personalised taper plan — gradual, responsive, with clear monitoring points and decision rules for what to do if symptoms change.

04

Coordinate and follow through

Liaison with your GP or specialist where appropriate. Follow-up available to review whether the plan is holding as expected.

Medication changes should never be made abruptly without clinical supervision. Every plan is built around safety first.

You leave with a clear written plan.

Not a recommendation to look things up. A written, personalised, medically defensible plan.

The decision

Continue, adjust, reduce, or stop — with the clinical reasoning documented clearly.

Taper schedule

Where deprescribing is appropriate — a specific, stepwise schedule with timeframes and decision points.

Monitoring strategy

What to watch for, at what intervals, and what would justify changing the plan.

Symptom management

What to expect and what to do if withdrawal or rebound symptoms emerge.

GP communication

A written summary to your GP where appropriate, keeping your care coordinated.

Follow-up plan

Clear markers for review and a pathway back if something changes.

"My job is to review the whole picture, then build a safe step-down plan you can actually follow."

Book a Medication Review

A doctor-led service. Not a prescription mill.

Most private clinics are set up to prescribe. This one is set up to review. The commercial incentive points in a different direction — and that matters when the question is whether to stop a medication, not start one.

Dr Dan Reardon is an NHS A&E doctor. Frontline emergency medicine gives a particular view of what happens downstream when medication management goes wrong — polypharmacy, missed indications, undertreated withdrawal. That experience shapes every review.

Not ideological. Not anti-medication. Clinically serious about getting the decision right.

NHS A&E DoctorFrontline emergency medicine · active
MB ChB · BSc · MScCardiff & Birmingham
GMC 6098984Fully registered
Doctor with a clinical focus in deprescribing and medication reviewGLP-1, SSRIs, PPIs, statins, antihypertensives
Former FitnessGenes CEOA decade in metabolic health and evidence-based physiology
CQC-Registered PracticeVia Sutton Medical Consulting, Sutton Coldfield

Consultation fees

Fees include advance review of your history and medication list, clinical interpretation, and a clear written plan.

Follow-up Review
£195
30 minutes

Progress review, results, plan refinement, and next-step decisions.

Results & Adjustment
£125
15 minutes

Medication adjustments or smaller changes to an existing plan.

For a comprehensive independent review of a full medication list — including a structured written clinical report — see the Independent Medication Review £1,200 → · View all fees →

Investigation costs are separate. Where further testing is indicated, the review will identify exactly which tests are needed and the most appropriate route — NHS, GP referral, or private lab.

FAQ

Is the outcome always to stop the medication?
No. Sometimes the outcome is continue — with reassurance and a documented reason. Sometimes it is reduce, adjust, or stop. The review is about arriving at the most defensible clinical decision for your situation, not achieving a predetermined outcome.
Can I stop my medication abruptly?
Many medications — SSRIs, PPIs, some antihypertensives, GLP-1s — require gradual tapering and monitoring. Abrupt stopping can cause withdrawal symptoms, rebound effects, or clinical deterioration. The review is designed to prevent that.
How much does a deprescribing consultation cost?
The Metabolic and Deprescribing Review is £395 for a 60-minute consultation, which includes advance review of your medication list, clinical assessment, a personalised step-down plan where appropriate, and a written plan to take away. Follow-up reviews are £195 for 30 minutes and £125 for 15 minutes.
How is this different from asking my GP to review my medication?
GPs manage a broad caseload under significant time pressure. A 10-minute appointment rarely allows for a thorough review of indication, risk-benefit, interactions, and a personalised step-down plan. This practice has a clinical focus in deprescribing and medication review — with the time and depth to do it properly.
Will you liaise with my GP?
Yes, where appropriate. A written summary can be sent to your GP to keep your care coordinated. Some plans work best in shared care — this is discussed during the review.
What if I am on a lot of medications?
The Medication List Review pathway covers polypharmacy — multiple medications from multiple prescribers. It maps the full regimen, identifies interactions and duplication, and produces a staged plan. For a more comprehensive formal assessment with a structured written clinical report, the Independent Medication Review is designed for exactly this.
What medications do you review?
GLP-1 weight-loss medications (Mounjaro, Wegovy, Ozempic), SSRIs and antidepressants, PPIs and reflux medications, statins, blood pressure medication, and complex polypharmacy where multiple medications from multiple prescribers have never been reviewed together.
Do you prescribe medication?
Where clinically appropriate, prescriptions can be arranged via SignatureRx and delivered to your home address. The service is not a route to new prescriptions — it is a clinical review focused on whether existing medications remain appropriate.

Understand before you decide.

Evidence-led guides on stopping specific medications — what happens, when to worry, and what a proper plan looks like.

All articles & evidence briefings →

Your prescription list should reflect who you are now.

Book a medication review and leave with a clear, clinician-led plan for what to continue, adjust, or stop.

Clinical appointments via CQC-registered Sutton Medical Consulting · Sutton Coldfield