Bramness Jørgen G, Skurtveit Svetlana, Neutel C Ineke, Mørland Jørg, Engeland Anders
Division of Epidemiology, Department of Pharmacoepidemiology, Norwegian Institute of Public Health, Oslo, Norway.
Pharmacoepidemiol Drug Saf. 2009 Jun;18(6):492-6. doi: 10.1002/pds.1740.
Studies have shown that lithium may cause psychomotor and cognitive impairment and impose an increased risk of traffic accidents. The antiepileptic drug valproate is also used as a mood stabilizer, but the impact on traffic safety has not been studied. The objective of the present study was to examine whether the use of lithium or valproate increased the risk of being involved in traffic accidents.
Between April 2004 and September 2006, information on prescriptions, road accidents and emigrations/deaths was obtained from three Norwegian population-based registries. Data on people between the ages 18-70 (3.1 million) were linked. Exposure consisted of receiving prescriptions for either lithium or valproate. Standardized incidence ratios (SIRs) were calculated by comparing the incidence of motor vehicle accidents during time exposed with the incidence over the time not exposed. Lithium was studied separately from valproate.
During the study period, 20,494 road accidents occurred including 36 while exposed to lithium and 31 while exposed to valproate. The overall accident risk was neither increased after having received prescriptions for lithium (SIR 1.3; 95%CI: 0.9-1.8), nor after having received a prescription for valproate (SIR 0.9; 0.6-1.3). The exception was a three-fold increase in risk for younger female drivers exposed to lithium.
We found no increase in the traffic accident risk after being exposed to lithium or valproate, except for young female drivers on lithium. This may be because these drugs carry no increased risk or because patients exposed to these drugs refrain from driving.
研究表明，锂可能会导致精神运动和认知障碍，并增加交通事故风险。抗癫痫药物丙戊酸盐也被用作情绪稳定剂，但尚未对其对交通安全的影响进行研究。本研究的目的是检验使用锂或丙戊酸盐是否会增加卷入交通事故的风险。
2004年4月至2006年9月期间，从挪威三个基于人群的登记处获取了处方、道路交通事故以及移民/死亡信息。将18至70岁（310万）人群的数据进行了关联。暴露因素包括接受锂或丙戊酸盐的处方。通过比较暴露期间机动车事故的发生率与未暴露期间的发生率，计算标准化发病率（SIR）。分别对锂和丙戊酸盐进行了研究。
在研究期间，共发生了20494起道路交通事故，其中36起发生在锂暴露期间，31起发生在丙戊酸盐暴露期间。接受锂处方后总体事故风险未增加（SIR 1.3；95%置信区间：0.9 - 1.8），接受丙戊酸盐处方后也未增加（SIR 0.9；0.6 - 1.3）。例外情况是暴露于锂的年轻女性驾驶员风险增加了两倍。
我们发现暴露于锂或丙戊酸盐后交通事故风险并未增加，但服用锂的年轻女性驾驶员除外。这可能是因为这些药物不会增加风险，或者是因为接触这些药物的患者避免驾驶。
