Benzodiazepine prescribing in chronic military-related PTSD: real-world patterns and correlates in specialized care.
12 affiliations
- 1MacDonald Franklin OSI Research Centre, Lawson Research Institute, London, ON, Canada.
- 2Department of Psychiatry, Western University, London, ON, Canada.
- 3Clinique TSO du CIUSSS de la Capitale Nationale, Québec, QC, Canada.
- 4Département de Psychiatrie et de Neurosciences, Faculté de Médecine, Université Laval, Québec, QC, Canada.
- 5Department of Psychiatry, University of Toronto, Toronto, ON, Canada.
- 6Ontario Shores Centre of Mental Health Sciences, Whitby, ON, Canada.
- 7Department of Psychiatry, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB, Canada.
- 8Deer Lodge Centre OSI Clinic, Winnipeg, MB, Canada.
- 9Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada.
- 10St. Joseph's OSI Clinic, St. Joseph's Health Care London, London, ON, Canada.
- 11Department of Clinical Health Psychology and Psychiatry, University of Manitoba, Winnipeg, MB, Canada.
- 12Lawson Research Institute, London, ON, Canada.
Abstract
Objective
To estimate the prevalence of benzodiazepine prescribing among patients with posttraumatic stress disorder (PTSD), identify patient- and practice-level correlates of benzodiazepine use, and examine the clinical rationale underlying prescribing decisions. We aimed to characterize real-world patterns and determinants of benzodiazepine use in a specialized tertiary care military and Veteran PTSD setting, where PTSD is often chronic and treatment-refractory, and to clarify the clinical factors associated with benzodiazepine prescribing.Methods
We conducted a cross-sectional study using clinician-reported data from 13 psychiatrists practicing in Canadian tertiary care Operational Stress Injury clinics. Psychiatrists provided current prescribing information for 438 military personnel and Veterans receiving treatment for a primary diagnosis of PTSD. Multivariable logistic regression examined associations between patient and provider characteristics, treatment history, and benzodiazepine prescribing. Analyses adjusted for age, sex, and clinical site, and accounted for clustering at the provider level.Results
Benzodiazepines were prescribed to 22% of patients. Use was more frequent among patients with longer PTSD duration and greater cumulative pharmacotherapy exposure. Each additional year of PTSD was associated with a 12% increase in adjusted odds of benzodiazepine use (OR 1.12, 95% CI 1.06-1.18). Patients with ≥ 5 years of pharmacotherapy exposure had two- to three-fold greater odds compared with those treated < 5 years. Benzodiazepine monotherapy was rare (< 1%), with most use occurring in combination with other psychotropic medications.Conclusions
In these specialized clinics, benzodiazepine use was more common among patients with persistent illness and extensive treatment histories. These patterns suggest use occurs primarily in the context of chronic and complex care, underscoring the importance of clear clinical guidance for real-world practice.
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BibTeX
@article{collins2026benzodiazepine,
title = {{Benzodiazepine prescribing in chronic military-related PTSD: real-world patterns and correlates in specialized care.}},
author = {Erin Collins and Jenny J W Liu and Mathieu Bilodeau and Amer M Burhan and Murray W Enns and Vicky Lavoie and Natalie Ein and Anthony Nazarov and Edouard Auger and Ken Balderson and Natalie Mota and Sonya Wanklyn and J Don Richardson},
journal = {Frontiers in psychiatry},
year = {2026},
month = oct,
doi = {10.3389/fpsyt.2026.1931305},
url = {https://europepmc.org/article/MED/42898444},
note = {CC BY},
}
RIS
TY - JOUR
TI - Benzodiazepine prescribing in chronic military-related PTSD: real-world patterns and correlates in specialized care.
AU - Erin Collins
AU - Jenny J W Liu
AU - Mathieu Bilodeau
AU - Amer M Burhan
AU - Murray W Enns
AU - Vicky Lavoie
AU - Natalie Ein
AU - Anthony Nazarov
AU - Edouard Auger
AU - Ken Balderson
AU - Natalie Mota
AU - Sonya Wanklyn
AU - J Don Richardson
PY - 2026
DA - 2026/10/05
JO - Frontiers in psychiatry
DO - 10.3389/fpsyt.2026.1931305
UR - https://europepmc.org/article/MED/42898444
AB - Objective To estimate the prevalence of benzodiazepine prescribing among patients with posttraumatic stress disorder (PTSD), identify patient- and practice-level correlates of benzodiazepine use, and examine the clinical rationale underlying prescribing decisions. We aimed to characterize real-world patterns and determinants of benzodiazepine use in a specialized tertiary care military and Veteran PTSD setting, where PTSD is often chronic and treatment-refractory, and to clarify the clinical factors associated with benzodiazepine prescribing.Methods We conducted a cross-sectional study using clinician-reported data from 13 psychiatrists practicing in Canadian tertiary care Operational Stress Injury clinics. Psychiatrists provided current prescribing information for 438 military personnel and Veterans receiving treatment for a primary diagnosis of PTSD. Multivariable logistic regression examined associations between patient and provider characteristics, treatment history, and benzodiazepine prescribing. Analyses adjusted for age, sex, and clinical site, and accounted for clustering at the provider level.Results Benzodiazepines were prescribed to 22% of patients. Use was more frequent among patients with longer PTSD duration and greater cumulative pharmacotherapy exposure. Each additional year of PTSD was associated with a 12% increase in adjusted odds of benzodiazepine use (OR 1.12, 95% CI 1.06-1.18). Patients with ≥ 5 years of pharmacotherapy exposure had two- to three-fold greater odds compared with those treated < 5 years. Benzodiazepine monotherapy was rare (< 1%), with most use occurring in combination with other psychotropic medications.Conclusions In these specialized clinics, benzodiazepine use was more common among patients with persistent illness and extensive treatment histories. These patterns suggest use occurs primarily in the context of chronic and complex care, underscoring the importance of clear clinical guidance for real-world practice.
SN - 1664-0640
ER -