Polypharmacy: When the Medication List Needs a SPRING CLEANING- Deprescribing More Than Refilling

If you’ve ever unfolded your medication list and thought, “Wow, this is…quite a list,” you’re not alone.

In medicine, we call it polypharmacy—a fancy word that simply means taking several medications at once (usually five or more). And for many adults managing high blood pressure, diabetes, cholesterol, arthritis, or sleep issues, it happens gradually. Somewhere along the way, an acid blocker lingered “just in case,” a beta-blocker was never revisited and a pill was added to treat the side effect of some other pill. Voilà: the prescribing cascade.

When you add all your supplements to this list, before you know it, your pill organizer needs its own organizer!

To be fair, many of these prescriptions are guideline-driven and lifesaving. Sometimes, though, medicines outstay their welcome. More pills mean more interactions, more side effects, more brain fog, and more of that familiar phrase: “I’m not sure what this one is for.” Adherence drops as complexity rises. So does fall risk.

One of the most high-yield interventions in outpatient medicine? A thoughtful medication review. That’s when we step back and ask: Does every medication on this list still earn its spot? The goal is not fewer medications just for the sake of it. The goal is the right medications.

And here’s a special shout out during Nurses Week to our incredible nurses. They are often the first to encounter unnecessary duplications, notice side effects, clarify confusing instructions, and help patients keep everything straight and in compliance. They are the quiet superheroes of medication safety.

If your medication list feels overwhelming, speak up. Reviewing it together might be one of the most important parts of your visit. Deprescribing is precision medicine with a trash can. And sometimes, the best prescription we write is the one we discontinue.

Smriti Goel, MD
April 28, 2026