Psychiatric clinicians frequently encounter complex prescribing decisions involving controlled substances, comorbid substance use, and competing clinical priorities. This session examines evidence-based approaches to prescribing and deprescribing benzodiazepines, stimulants, and other high-risk medications while balancing symptom management, safety, and patient-centered care. Faculty will review risk assessment strategies, monitoring considerations, withdrawal management, and practical approaches to challenging clinical scenarios commonly encountered in psychiatric practice.