Laux G, Brunnauer A
Institut für Psychologische Medizin (IPM), Oberwallnerweg 7, 83527, Haag i.OB, Deutschland,
Nervenarzt. 2014 Jul;85(7):822-8. doi: 10.1007/s00115-013-3994-2.
There are only few data available regarding the effects of depressive disorders on road safety due to methodological shortcomings. Patients with acute severe depression or manias are unqualified for driving but after clinical remission driving ability can be attested under psychiatric supervision in most cases. So far there are only few data available about a patient's fitness to drive under psychotropic medication. Regarding the effects of antidepressants on road safety depressed patients obviously benefit from treatment with newer antidepressants; however, at least some subgroups of patients do not reach the performance level of healthy subjects. Approximately 17 % of remission bipolar patients must be regarded as unable to drive and 27 % of patients with schizophrenia on discharge from hospital. Benzodiazepines are clearly associated with increased risk of road traffic accidents. Impaired driving ability of young attention deficit hyperactivity disorder (ADHS) patients is improved under treatment with methylphenidate. Counselling patients with respect to driving ability must be carried out individually taking into account factors of the illness, personality, attitudes and coping strategies as well as different psychopharmacological effects.
由于方法学上的缺陷，关于抑郁症对道路安全影响的数据非常有限。患有急性重度抑郁症或躁狂症的患者不具备驾驶资格，但在临床缓解后，大多数情况下在精神科监督下可以证明其驾驶能力。到目前为止，关于患者在服用精神药物情况下的驾驶适宜性的数据很少。关于抗抑郁药对道路安全的影响，抑郁症患者显然从使用新型抗抑郁药治疗中获益；然而，至少某些亚组患者未达到健康受试者的表现水平。约17%缓解期双相情感障碍患者必须被视为无驾驶能力，27%的精神分裂症患者出院时也如此。苯二氮䓬类药物显然与道路交通事故风险增加有关。患有注意力缺陷多动障碍（ADHD）的年轻患者在使用哌甲酯治疗后驾驶能力受损的情况有所改善。必须根据疾病因素、个性、态度和应对策略以及不同的精神药理作用，对患者的驾驶能力进行个体化咨询。
