Université Bordeaux Segalen, Equipe Injury Prevention and Control (PPCT), Institute of Public Health, Epidemiology, and Development (ISPED), Centre INSERM U897-Epidemiologie-Biostatistique, F-33000, Bordeaux, France.
J Clin Psychiatry. 2012 Aug;73(8):1088-94. doi: 10.4088/JCP.11m07624.
To estimate the risk of road traffic crash associated with prescription of antidepressants.
Data were extracted and matched from 3 French national databases: the national health care insurance database, police reports, and the national police database of injurious crashes. A case-control analysis comparing 34,896 responsible versus 37,789 nonresponsible drivers was conducted. Case-crossover analysis was performed to investigate the acute effect of medicine exposure.
72,685 drivers, identified by their national health care number, involved in an injurious crash in France from July 2005 to May 2008 were included. 2,936 drivers (4.0%) were exposed to at least 1 antidepressant on the day of the crash. The results showed a significant association between the risk of being responsible for a crash and prescription of antidepressants (odds ratio [OR] = 1.34; 95% CI, 1.22-1.47). The case-crossover analysis showed no association with treatment prescription, but the risk of road traffic crash increased after an initiation of antidepressant treatment (OR = 1.49; 95% CI, 1.24-1.79) and after a change in antidepressant treatment (OR = 1.32; 95% CI, 1.09-1.60).
Patients and prescribers should be warned about the risk of crash during periods of treatment with antidepressant medication and about particularly high vulnerability periods such as those when a treatment is initiated or modified.
评估与抗抑郁药物处方相关的道路交通事故风险。
从法国的三个国家数据库中提取和匹配数据：国家医疗保险数据库、警察报告和伤害性事故国家警察数据库。对 34896 名负责驾驶员和 37789 名非负责驾驶员进行了病例对照分析。采用病例交叉分析来研究药物暴露的急性效应。
纳入了 2005 年 7 月至 2008 年 5 月期间在法国因受伤而发生事故的 72685 名驾驶员，他们的国民健康号码均已识别。有 2936 名驾驶员（4.0%）在事故发生当天至少服用了 1 种抗抑郁药。结果显示，发生事故的责任风险与抗抑郁药的处方之间存在显著关联（比值比[OR] = 1.34；95%CI，1.22-1.47）。病例交叉分析显示与治疗性处方无关联，但抗抑郁药治疗开始后（OR = 1.49；95%CI，1.24-1.79）和治疗改变后（OR = 1.32；95%CI，1.09-1.60）发生道路交通事故的风险增加。
患者和处方医生应注意在抗抑郁药物治疗期间发生事故的风险，特别是在开始或改变治疗时的高脆弱性期间。
