Most often, my public reflections center on the fair and ethical treatment of animals. That cause has shaped much of my work and my voice. But today, I step away from that familiar ground to reflect on something both personal and tragically widespread.

Until recently, I had never encountered the term polypharmacy. I did not know it referred to the practice of prescribing multiple psychiatric medications simultaneously, nor that it could carry profound — and sometimes dangerous — consequences. I learned the word only after my partner, Nancy, took her own life at the age of 54.

Her death opened my eyes to a crisis that affects countless families across the country: the quiet, often unseen toll of polypharmacy — the layering of one psychiatric drug upon another until dependence, confusion, and risk overtake the promise of healing. Millions now live at the mercy of pharmaceutical regimens that may stabilize for a time but too often destabilize in the long run.

In the weeks since, I have been searching for answers — about her care, her prescriptions, and whether the very treatments intended to help her may have contributed to her death. 

Reviewing her records and psychiatric evaluations was sobering. I found a succession of potent medications — antidepressants, benzodiazepines, mood stabilizers — prescribed by different providers across multiple facilities, often with little regard for her prior usage, the cumulative effects, or the potential for dangerous drug interactions. 

Each new prescription seemed to exist in isolation, detached from her broader history and the complexity of her condition.

Over time, Nancy developed a dependence on the very medications meant to manage her symptoms. When one physician declined to renew a prescription, she would sometimes turn — desperately — to another provider or hospital. This cycle became a struggle for stability that remained elusive. 

At times, she endured it in silence — sleeping for days, withdrawing from loved ones, isolating herself from family and support. For those of us who loved her most deeply, the weight of her absence is compounded by lingering questions: what more could we have done, and might her death have been preventable?

The last months of her life illustrate the problem. After she broke her leg, Nancy was prescribed an opioid painkiller. Was there any careful consideration of how this would interact with her psychiatric medications, or whether it could destabilize her? If there was, we never heard it. The reflexive answer was always another pill.

Research confirms what we witnessed firsthand. Polypharmacy significantly increases the risk of adverse drug events, particularly in fragmented systems where patients see multiple prescribers. The FDA’s own black box warnings note that certain antidepressants may increase suicidal ideation, especially during dosage changes. Yet in practice, these warnings are too often minimized or ignored.

We can do better. Four reforms could save lives:

Mandatory interaction reviews. Every psychiatric prescription should be screened for drug–drug interactions before initiation and at every refill.

Enhanced informed consent. Patients and families deserve clear explanations of both benefits and risks, including the possibility of worsening suicidal thoughts.

Integrated care models. Medication management should be one part of a broader treatment plan that includes non-drug supports.

Continuity of care. Patients need a consistent primary prescriber or care coordinator to reduce dangerous fragmentation.

Psychiatric medications can save lives — but they can also endanger them. My partner’s story raises urgent questions: Why are we so quick to add medications without fully considering their long-term impact? Why is accountability so rare when harm occurs?

I cannot bring Nancy back. But I can use her story to demand a better system—one where prescribing psychiatric drugs is treated with the same rigor and caution we apply to other life-threatening conditions.

Lives depend on it.

Paul Barthel lives in Cary, Illinois.