A national outpatient study found modest reductions in benzodiazepine use from 2013 to 2022, while other measures of medication burden changed less consistently.
A study of prescribing patterns
Vidal and colleagues analyzed the French National Health Data System to examine psychotropic treatment among adults with schizophrenia spectrum or bipolar disorders. The final sample included 836,602 adults. The study followed medication deliveries during 2013–2022 and compared patterns across diagnostic and age groups.
The investigators examined the number and standardized daily dose of psychotropic drugs, anticholinergic burden, anticholinergic-agent use, and benzodiazepine use. These are related measures, but none can serve as a complete substitute for the others. Reducing one class does not necessarily reduce a patient’s total exposure to medicines with potential cognitive effects.
The benzodiazepine trend
The paper reported statistically significant annual declines in benzodiazepine-use frequency across its diagnostic and age categories. Estimates ranged from roughly 0.26 to 0.88 percentage points per year. Those are changes in group-level frequency, not a finding that an individual patient’s dose fell by the same amount.
The authors also observed small decreases in the number and total standardized dose of psychotropic medications in most groups. However, anticholinergic burden remained broadly constant. Most movement toward less prescribing halted after 2020, according to the report. The different trajectories argue against describing the period as a uniform reduction in all forms of medication burden.
Claims cannot establish ingestion or cognitive recovery
Medication delivery records describe access to treatment. The authors lacked adherence data and acknowledged that not every delivered medicine is necessarily used as assumed. Their analysis also concerned outpatients, limiting transfer of the findings to inpatient care.
The study did not determine why the trends occurred. Guideline changes, clinician behavior, available treatments, and other influences could contribute. Nor did it demonstrate that reducing benzodiazepine deliveries produced a measured improvement in cognition in these patients.
What to ask of an individual record
For a forensic review, the study supports separating dispensing history from actual administration and separating a benzodiazepine prescription from the rest of the medication regimen. A meaningful chronology should identify overlapping agents and dose changes rather than treating one population trend as proof of exposure or recovery in a particular person. The paper’s contribution is a large-scale description of practice, with causal explanations left unresolved.
Source paper
Original analysis of the supplied journal article, identified as PMC13040571.
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