Polypharmacy isn’t just about medication count—it’s about cumulative risk and unintended consequences. One of the biggest drivers is the prescribing cascade, where a drug side effect is mistaken for a new condition, and another medication gets added instead of addressing the root cause.

You see this all the time in practice. A patient starts amlodipine and develops edema, then gets placed on furosemide. Or donepezil leads to urinary symptoms, and oxybutynin is added—potentially worsening cognition. These patterns add risk quickly.

In this episode, I’ll break down common examples that I have recently encountered in practice.

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