Brunnauer Alexander, Laux Gerd, David Irmgard, Fric Mirijam, Hermisson Igor, Möller Hans-Jürgen
Inn-Salzach-Hospital, Academic Hospital of Psychiatry, Psychotherapy, and Neurology, Wasserburg am Inn, Germany.
J Clin Psychiatry. 2008 Dec;69(12):1880-6. doi: 10.4088/jcp.v69n1205. Epub 2008 Oct 7.
The aim of the present study was to examine the influence of reboxetine and mirtazapine on psychomotor functions related to driving skills and on driving simulator performance in depressed inpatients.
Forty depressed inpatients diagnosed according to DSM-IV-TR criteria were randomly assigned to treatment with either reboxetine (N = 20) or mirtazapine (N = 20). To control for retest effects in psychomotor measures, a group of 10 healthy controls was examined on the same time schedule. Participants were tested once before pharmacologic treatment and twice after initiation of treatment (days 7 and 14) with computerized tests related to car-driving skills. Data were collected with the Act and React Testsystem ART-90 and the Wiener Testsystem, measuring visual perception, reactivity, stress tolerance, concentration, and vigilance. In addition, patients went through various risk simulations on a static driving simulator. Data were analyzed with nonparametric statistics and repeated-measures analysis of variance. The study was conducted from June 2004 through June 2006.
Before onset of treatment with antidepressants, about 65% of patients did not reach the threshold criterion according to the German guidelines for road and traffic safety. After 14 days of treatment with reboxetine or mirtazapine, patients improved in driving ability skills. Controlling for retest effects in psychomotor measures, data indicate that both patient groups significantly improved in tests measuring selective attention and reactivity (all p < .01). Furthermore, the frequency of accidents in the risk simulations markedly decreased in patients receiving mirtazapine and reboxetine (all p < .05). Statistically significant differences between treatment groups could not be shown.
Our results indicate that partially remitted depressed inpatients treated with reboxetine or mirtazapine show a better performance on tasks related to driving skills than do untreated depressives.
本研究旨在探讨瑞波西汀和米氮平对抑郁症住院患者与驾驶技能相关的精神运动功能以及驾驶模拟器表现的影响。
根据《精神疾病诊断与统计手册》第四版修订版（DSM-IV-TR）标准诊断的40例抑郁症住院患者被随机分为瑞波西汀治疗组（N = 20）或米氮平治疗组（N = 20）。为控制精神运动测量中的重测效应，对一组10名健康对照者在相同时间安排下进行检查。参与者在药物治疗前进行一次测试，在治疗开始后（第7天和第14天）进行两次与驾驶技能相关的计算机化测试。使用Act and React Testsystem ART-90和Wiener Testsystem收集数据，测量视觉感知、反应性、应激耐受性、注意力和警觉性。此外，患者在静态驾驶模拟器上进行各种风险模拟。数据采用非参数统计和重复测量方差分析进行分析。该研究于2004年6月至2006年6月进行。
在开始使用抗抑郁药治疗前，约65%的患者未达到德国道路交通安全指南规定的阈值标准。使用瑞波西汀或米氮平治疗14天后，患者的驾驶能力有所改善。控制精神运动测量中的重测效应后，数据表明两个患者组在测量选择性注意力和反应性的测试中均有显著改善（所有p < .01）。此外，接受米氮平和瑞波西汀治疗的患者在风险模拟中的事故发生率显著降低（所有p < .05）。未显示治疗组之间有统计学显著差异。
我们的结果表明，接受瑞波西汀或米氮平治疗的部分缓解的抑郁症住院患者在与驾驶技能相关的任务上比未治疗的抑郁症患者表现更好。
