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Gradual dose reduction and medication tapering: a clinical perspective.

Recent changes in the State Operations Manual put new emphasis on attempts to gradually reduce the dose of certain medications -- namely psychotropic medications -- as a component of medication management in nursing facilities. Applying these federal guidelines to caring for elderly patients is often highly complex. It requires an understanding of existing clinical evidence, the current standards of practice for using these medications, and the appropriate rationale for attempting to reduce drug dosages.