{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T15:07:09Z","timestamp":1789744029228,"version":"4.0.1"},"reference-count":43,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T00:00:00Z","timestamp":1789689600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T00:00:00Z","timestamp":1789689600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Br J Clin Pharmacol"],"abstract":"<jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Benzodiazepines (BZDs) are commonly prescribed for anxiety and insomnia but carry risks such as dependence, adverse drug reactions (ADRs) and mortality. Despite deprescribing efforts, the influence of recent prescribing trends, COVID\u201019 and adverse outcomes on prescribing patterns in England remains uncertain. This study evaluates trends in BZD prescribing, costs, and safety outcomes and explores their socioeconomic associations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This population\u2010level observational study analysed prescribing, cost and ADR data for 14 BZDs using national datasets. Prescribing rates were standardized per 100\u2009000 population, fatality ratios were calculated, and regression models assessed yearly changes by drug, region, and pandemic phase. Socioeconomic influences on prescribing were analysed using a generalized additive model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Total BZD prescribing decreased from 15562.34 items per 100\u2009000 population in 2020 to 12284.01 in 2025, a mean annual change of \u22124.3% (95% CI: \u22124.5% to \u22124.03%), largely because of reduced prescribing of diazepam, temazepam and chlordiazepoxide. Conversely, specialist\u2010use agents increased, including clobazam (6.36% per year, 95% CI: 0.34% to 12.39%) and midazolam (1.03% per year, 95% CI: \u22121.30% to 3.37%). Ethnicity influenced deprivation\u2010related prescribing patterns, indicating disparities beyond socioeconomic status. The average lifetime fatality ratio across all BZDs was 4.5 deaths per 100 reported cases, with oxazepam the highest (17.9), followed by lorazepam (9.1) and alprazolam (8.6).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Benzodiazepine prescribing in England continues to decline, reflecting successful deprescribing policies. However, increasing specialist use, persistent inequities, and drug\u2010specific safety and cost concerns highlight the need for cautious prescribing, enhanced pharmacovigilance and equitable access.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/bcp.70824","type":"journal-article","created":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T14:29:01Z","timestamp":1789741741000},"source":"Crossref","is-referenced-by-count":0,"title":["Benzodiazepines use in primary care England: Prescribing patterns and adverse consequences"],"prefix":"10.1002","author":[{"given":"Alvina","family":"Chaudhry","sequence":"first","affiliation":[{"name":"Department of Pharmacy, School of Applied Sciences University of Huddersfield  Huddersfield UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-1284-5929","authenticated-orcid":false,"given":"Muhammad Umair","family":"Khan","sequence":"additional","affiliation":[{"name":"Aston Pharmacy School, School of Medicine, Pharmacy and Biosciences Aston University  Birmingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara","family":"Conway","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, School of Applied Sciences University of Huddersfield  Huddersfield UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4058-2215","authenticated-orcid":false,"given":"Syed Shahzad","family":"Hasan","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, School of Applied Sciences University of Huddersfield  Huddersfield UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,18]]},"reference":[{"key":"e_1_2_9_2_1","volume-title":"Mental health: Strengthening mental health promotion","author":"World Health Organization","year":"2001"},{"key":"e_1_2_9_3_1","volume-title":"Mental health statistics: prevalence, services and funding in England","author":"Baker C","year":"2024"},{"key":"e_1_2_9_4_1","unstructured":"McDaidD ParkAL DavidsonG et al.The economic case for investing in the prevention of mental health conditions in the UK.2022."},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1360\u20100443.2011.03563.x"},{"key":"e_1_2_9_6_1","unstructured":"EnglandN.Optimising personalised care for adults prescribed medicines associated with dependence or withdrawal symptoms.2022."},{"key":"e_1_2_9_7_1","unstructured":"DrugWise.Benzodiazepines.2020."},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2016.303061"},{"key":"e_1_2_9_9_1","volume-title":"Dependence and Withdrawal Associated with Some Prescribed Medicines","author":"Taylor S","year":"2019"},{"key":"e_1_2_9_10_1","doi-asserted-by":"crossref","DOI":"10.1136\/bmj.g5205","article-title":"Benzodiazepine use and risk of Alzheimer's disease: case\u2010control study","volume":"349","author":"De Gage SB","year":"2014","journal-title":"BMJ"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amepre.2015.03.040"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1002965"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamapsychiatry.2014.1763"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.2165\/00023210\u2010200418010\u201000004"},{"key":"e_1_2_9_15_1","unstructured":"NICE guideline [CG113].Generalised anxiety disorder and panic disorder in adults: Management.2019.https:\/\/www.nice.org.uk\/guidance\/cg113"},{"key":"e_1_2_9_16_1","unstructured":"FDA Drug Safety Communication.FDA requiring Boxed Warning updated to improve safe use of benzodiazepine drug class.2020.https:\/\/www.fda.gov\/drugs\/drug-safety-and-availability\/fda-requiring-boxed-warning-updated-improve-safe-use-benzodiazepine-drug-class"},{"key":"e_1_2_9_17_1","unstructured":"European Medicines Agency.Annual report on EudraVigilance for the European Parliament the Council and the Commission.2020."},{"key":"e_1_2_9_18_1","unstructured":"National Institute for Health and Care Excellence.Clinical guideline: Anxiety disorders.2014.https:\/\/www.nice.org.uk\/guidance\/qs53\/resources\/anxiety-disorders-pdf-2098725496261"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2215\u20100366(18)30471\u20101"},{"key":"e_1_2_9_20_1","unstructured":"WilliamsT DavisJ FigueiraC VizardT.Coronavirus and depression in Coronavirus and depression in adults Great Britain: January to March 2021. 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