Psychopharmacology Unit, University of Bristol, School of Medical Sciences, University Walk, Bristol BS8 1TD, UK.
J Psychopharmacol. 1996 Jan;10(2):141-5. doi: 10.1177/026988119601000209.
The safety of sedative antidepressants is a topical issue in the treatment of depression, with driving impairment being of particular concern. We have recently completed a study with normal male volunteers comparing the actions of dothiepin (a traditional, sedating antidepressant) with those of fluvoxamine (one of the selective serotonin re-uptake-inhibiting SSRI class of newer antidepressants) on psychomotor functions relevant to driving. We set out to investigate whether these drugs impair visual selective attention (focused and divided) by employing the 'odd-ball' task. Subjects were required to respond to letters of the alphabet (T for target and other letters for non-targets) that were presented at the centre and/or periphery of the computer screen. The task has been shown to be useful in detecting differences between drugs in their effects on selective attention. Preliminary results show that dothiepin delayed responses to single targets compared with fluvoxamine and placebo. There was also preliminary evidence that it mainly affected response times to peripheral targets. Furthermore, there was preliminary evidence that both drugs delayed responses to central targets compared with placebo on the divided attention trials. Finally, response accuracy in detecting peripheral targets was greater under placebo compared with fluvoxamine and dothiepin. The impairment produced by dothiepin is presumably a consequence of the central blockade of cholinergic muscarinic or histaminergic H1 receptors. It could contribute to the reported association between the tricyclic class of antidepressants and road traffic accidents, and would be worth further investigation in depressed patients taking both classes of drug.
镇静型抗抑郁药的安全性是治疗抑郁症的一个热门话题，其中驾驶障碍尤其令人关注。我们最近完成了一项针对正常男性志愿者的研究，比较了多塞平（一种传统的镇静型抗抑郁药）和氟伏沙明（一种选择性 5-羟色胺再摄取抑制剂（SSRIs）类新型抗抑郁药）对与驾驶相关的精神运动功能的作用。我们旨在研究这些药物是否通过“Odd-Ball”任务损害视觉选择性注意（集中和分散）。要求受试者对呈现在计算机屏幕中心和/或外围的字母（T 代表目标，其他字母代表非目标）做出反应。该任务已被证明可用于检测药物对选择性注意的影响差异。初步结果表明，与氟伏沙明和安慰剂相比，多塞平延迟了对单个目标的反应。还有初步证据表明，它主要影响外周目标的反应时间。此外，还有初步证据表明，与安慰剂相比，两种药物在分散注意力试验中均延迟了对中央目标的反应。最后，在检测外周目标时，安慰剂下的反应准确性高于氟伏沙明和多塞平。多塞平引起的损害可能是由于其对中枢胆碱能毒蕈碱或组胺能 H1 受体的阻断作用所致。它可能与三环类抗抑郁药与道路交通事故之间的报道关联有关，对于同时服用这两类药物的抑郁症患者，值得进一步研究。
