Objective:

To evaluate whether initiation of psychotherapy is associated with short-term changes in psychotropic medication exposure and regimen complexity, and to examine differences by sex, age, and diagnostic category.

Approach:

Key Findings:

• Thecohortcomprised86,502patientsand20.76milliondispensations.Themediannumberofpsychotropicmedicationsdecreasedfrom5to2(p<0.001).Totaldoseremainedstable(medianDefinedDailyDose≈21.7;p=0.999).Benzodiazepineusedeclinedfrom87.6%to67.5%andantidepressantusefrom81.8%to68.8%(bothp<0.001).Menweremorelikelythanwomentodiscontinuebenzodiazepines(oddsratio1.27,95%CI1.13–1.43).Simplificationincreasedwithage,withthelargestbenzodiazepinereductionsoccurringindepressive,personality,andepisodicmooddisorders.

Interpretation:

In routine public mental health care, psychotherapy initiation is associated with substantial simplification of psychotropic treatment regimens without increasing overall medication dose.

Conclusion:

The study supports a potential role of psychotherapy in facilitating rational medication simplification.

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