Polypharmacy Without Proof—and Why We Keep Guessing Instead of Measuring

The January 2023 deaths of three young children in Duxbury, Massachusetts, continue to force an uncomfortable conversation about psychiatric prescribing. Court records show that Lindsay Clancy was prescribed approximately thirteen different psychiatric medications in the four months leading up to the tragedy. The list included sertraline (Zoloft), fluoxetine (Prozac), mirtazapine (Remeron), trazodone, amitriptyline, quetiapine (Seroquel), lamotrigine (Lamictal), lorazepam (Ativan), clonazepam (Klonopin), diazepam (Valium), buspirone, zolpidem (Ambien), and hydroxyzine—often started, stopped, or adjusted across multiple providers in rapid succession.

Simple math makes the scale of the problem clear. With 13 distinct medications available, the number of possible different combinations (every possible subset) is 213=8,192213=8,192. Even if we restrict the calculation to realistic concurrent “cocktails” of three to six agents at a time, the number of distinct versions still runs into the thousands. None of those combinations has been systematically tested in rigorous randomized controlled trials for safety or efficacy in postpartum presentations or similar complex cases. Dense polypharmacy of this intensity is largely an uncontrolled experiment.

Some bottles remained largely full. Toxicology confirmed the presence of several agents. Defense arguments focused on overmedication and destabilization; prosecutors highlighted incomplete adherence and other factors. Whatever the final legal outcome, one clinical reality stands: no amount of explanation converts an unstudied multi-drug stack into proven treatment.

The Pattern That Keeps Repeating

As board-certified psychiatrist, former FDA drug regulator, and founder of TaperClinic Dr. Josef Witt-Doerring has observed in commenting on this case, the pattern is not rare even if the catastrophic outcome is. Someone starts a psychiatric medication for a legitimate reason—depression, anxiety, or a difficult life period. Instead of feeling better, they become more anxious, restless, foggy, emotionally numb, or unlike themselves. They (and often their family) report that they are getting worse. Those symptoms are interpreted as the original condition worsening. The dose is increased or another psychiatric medication is added. The person deteriorates further, and the cycle continues.

This is not always because the doctor does not care. Often the clinician is following the approach they were trained to use and does not recognize that the medication itself may be contributing to the problem. That cycle is exactly why so many people eventually seek specialized tapering care after years of being told they need more treatment while quietly wondering whether the treatment has become part of the problem.

Care Fragmentation Makes It Worse

I saw a parallel form of this fragmentation decades ago while serving as director of epidemiology at the Maricopa County health department in the late 1980s and early 1990s. We encountered cases in which the same individual had been seen for repeated suicide attempts at multiple hospitals across the Phoenix area. Providers at one facility had little or no communication with those at the others. No one held the full picture. The system treated discrete episodes instead of a continuous person. The same pattern appears in psychiatric prescribing today: multiple clinicians, serial medication changes, limited shared data, and little systematic tracking of whether the accumulating cocktail is helping or harming.

Psychiatrists Guess. Other Specialists Look.

Dr. Daniel Amen has made this point forcefully in his TED talk and related work: psychiatrists are essentially the only medical specialists who virtually never look at the organ they treat. Cardiologists look. Neurologists look. Orthopedists look. Psychiatrists largely diagnose and prescribe by talking and guessing. There is still no blood test that confirms “depression” or “anxiety” as discrete biological diseases the way we confirm diabetes or hypothyroidism. Yet powerful psychoactive drugs are peddled daily as if they heal a known brain lesion.

At Atlanta BrainMax Wellness and Circle C Wellness we refuse that approach. We measure. Quantitative EEG brain mapping, symptom scales, heart-rate variability, and related tools give us objective data so we can see patterns of dysregulation rather than invent them. The same philosophy underpins Mindful Neurotrauma Cognitive Behavioral Therapy Mitigation—the measurement-driven extension of Trauma-Informed Mindful Cognitive Behavioral Therapy developed for the critical post-trauma neuroplasticity window. We integrate trauma-informed mindful CBT, advanced reprocessing methods, photobiomodulation, and qEEG-guided neurofeedback while tracking outcomes rather than stacking unproven combinations.

Root causes matter. Healthy diet and regular exercise have stronger, more consistent evidence as foundational interventions for mood, anxiety, sleep, and cognitive function than many of the psychiatric agents routinely prescribed. Addressing sleep, inflammation, trauma history, cognitive patterns, movement, and nutrition is not “alternative.” It is basic medicine that too often gets skipped in favor of the next prescription.

What a Better System Would Require

Regardless of political affiliation, the arithmetic is straightforward: if the United States can spend roughly four million dollars each time it launches certain interceptors in the Middle East, it can invest serious resources in a mental health system that prioritizes measurement, continuity of care, and careful deprescribing over reflexive polypharmacy. That system must rein in indiscriminate prescribing and the commercial incentives that treat more drugs as the default solution. It must create shared records that prevent the care fragmentation I witnessed in Maricopa County. And it must stop pretending that the absence of any confirmatory blood test for depression or anxiety somehow justifies treating complex human distress as a simple chemical deficit that additional medications will fix.

For people already trapped in long medication lists, specialized tapering clinics offer a practical next step under medical supervision:

1. TaperClinic (taperclinic.com) – Virtual U.S. clinic focused exclusively on psychiatric medication tapering and recovery from drug-related injury. Led by Dr. Josef Witt-Doerring; has helped more than 400 people safely reduce or come off medications.

2. Outro Health (outro.com) – Clinician-guided antidepressant tapering using hyperbolic methods and ongoing support.

3. Rittenhouse Psychiatric Associates (rittenhousepa.com) – Physician-guided tapering with compounding options and telehealth.

4. Resilient Mind Clinic (resilientmindclinic.com) – Structured deprescribing for benzodiazepines, antidepressants, and sleep aids using slow, symptom-responsive approaches.

These are not magic solutions, and they are not appropriate for every person. They represent recognition that helping people carefully reduce burdensome regimens is a legitimate clinical specialty.

At BrainMax and Circle C Wellness the core commitment remains the same: measure rather than guess, address root causes, and treat people as whole human beings whose brains can change when we support them properly. Real recovery still requires a plan, practice, and persistence. Patients and families deserve a system that finally treats that truth as more important than the next prescription.

For more on trauma-informed mindful cognitive behavioral therapy, measurement-based neurotherapy, and practical alternatives to endless medication escalation, visit https://www.galencole.com/brainmax and circlecwellness.com.

Related peer-reviewed paper: Cole, G.E. (2026). Mindful Neurotrauma Cognitive Behavioral Therapy Mitigation: A Multimodal Extension of Trauma-Informed Mindful Cognitive Behavioral Therapy for Acute Trauma. Medical Research Archives, 14(7). https://doi.org/10.18103/mra.2026.0384

© 2026 Galen E. Cole. This original work may not be reproduced without permission.