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ArticleClinical drug investigation2025

Off-Label Prescription of Benzodiazepines: A Retrospective Cohort Study of Prescribing Prevalence in Primary Care.

Kevin Trimm, Maria-Teresa Moraga, Bärbel Knäuper, Elham Rahme, Emily Gibson McDonald, Robyn Tamblyn

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Article in Clinical drug investigation, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Kevin TrimmDepartment of Experimental Medicine, McGill University, 845 Sherbrooke Street West, Montreal, QC, H3A 2T5, Canada. kevin.trimm@mail.mcgill.ca.ORCID http://orcid.org/0009-0002-1939-4217
Maria-Teresa MoragaDepartment of Epidemiology, Biostatistics, Occupational Health, McGill University, Montreal, QC, Canada.
Bärbel KnäuperDepartment of Psychology, McGill University, Montreal, QC, Canada.
Elham RahmeDepartment of Epidemiology, Biostatistics, Occupational Health, McGill University, Montreal, QC, Canada.
Emily Gibson McDonaldDepartment of General Internal Medicine, McGill University, Montreal, QC, Canada.
Robyn TamblynDepartment of Epidemiology, Biostatistics, Occupational Health, McGill University, Montreal, QC, Canada.

Funding

canadian institute of health research 93528
6 · The paper itself

Abstract

BACKGROUND AND

objectivesBenzodiazepines are commonly prescribed medications approved for and used in the treatment of anxiolytic and sleep disorders, as well as for seizures, and alcohol withdrawal. However, benzodiazepines are also controlled substances because of their potential for abuse and personal harm, which are especially prevalent among older people. It is therefore important to understand how benzodiazepines are being prescribed, and the prevalence of off-label benzodiazepine prescribing, of which very little is known because of challenges in documenting treatment indication. The aim of this study was to detail the prevalence of benzodiazepine off-label prescribing.

methodsData from the MOXXI (Medical Office of the XXIst century) electronic health record system in Quebec Canada were used, where specifying the treatment indication for each prescription is required, to estimate the prevalence of off-label prescribing and indications for off-label use of benzodiazepines. Each drug indication was retrospectively classified as either on-label or off-label according to the Health Canada drug database. Off-label prescriptions were further classified as having class congruence supporting their prescription if another benzodiazepine had been approved for the indication by Health Canada.

resultsThere were 20,125 (17.0%) adult patients prescribed benzodiazepines out of the 118,223 patients enrolled in the MOXXI system. The patients were predominantly female (65.6%) and tended to be older with an average age of 60.14 years at the time of the first benzodiazepine prescription. A total of 101,583 unique prescriptions were written for 14 different benzodiazepines. An approximately equal number of benzodiazepines were prescribed on- and off-label (49.3% on-label, 49.2% off-label). Most off-label prescription indications were classified as having class congruence (95.2%).

conclusionsBenzodiazepines were frequently prescribed in the province of Quebec and were prescribed off-label approximately half of the time. When prescribed off-label, we found that most of these prescriptions were for indications that were approved for other benzodiazepines. The most common indication for off-label benzodiazepine prescriptions with class congruence was insomnia.

Indexed as

BenzodiazepinesOff-Label UsePractice Patterns, Physicians'Primary Health CareAdolescentAdultAgedAged, 80 and overCohort StudiesFemaleHumansMaleMiddle AgedPrevalenceQuebecRetrospective StudiesBenzodiazepines

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.