Judd L L
Accid Anal Prev. 1985 Aug;17(4):319-22. doi: 10.1016/0001-4575(85)90033-8.
Despite the extremely widespread use of antipsychotic medications, there is little evidence from the surveys conducted to date, that this class of psychoactive medications is significantly implicated in vehicular crashes or deaths. In five major surveys of vehicular fatalities, in which drug and alcohol analyses were obtained, only two of over 800 victims studied involved detection of antipsychotic medications. It is clear that the acute administration of antipsychotics in normal individuals does induce sedation and performance decrements in visual-motor coordination and specific attentional behaviors, which have a deleterious effect on driving behavior. On the other hand, it should be emphasized that antipsychotics are rarely used on an acute basis and tolerance to the sedation and decreased alertness does occur during chronic treatment. Antipsychotic drugs have the capacity to potentiate the effects of alcohol, sedative hypnotics, narcotics and antihistamines; therefore, the combination of antipsychotics with these substances increases the impairment of driving behavior. There is an indication that the less sedating piperazine phenothiazines and the butyrophenones may have little or no effect on psychomotor performance, and antipsychotic drugs of these two subclasses may have a distinct advantage, at least in terms of driving performance, over the other more sedating drugs. Antipsychotic drugs are almost never used for recreational or abuse purposes; therefore, more central to the focus of this review is the effect that antipsychotics may have on the driving behavior of those seriously disordered mentally ill patients who require continued maintenance on these medications. There is good agreement in the literature which suggests that schizophrenic patients demonstrate improved psychomotor performance during chronic treatment with antipsychotic drugs.(ABSTRACT TRUNCATED AT 250 WORDS)
尽管抗精神病药物的使用极为广泛，但迄今为止的调查几乎没有证据表明这类精神活性药物与车祸或死亡有显著关联。在五项对车祸死亡者进行毒品和酒精分析的 major 调查中，在研究的800多名受害者中，只有两人检测出使用了抗精神病药物。显然，正常个体急性服用抗精神病药物确实会导致镇静，并使视觉运动协调和特定注意力行为的表现下降，这对驾驶行为有有害影响。另一方面，应该强调的是，抗精神病药物很少用于急性治疗，而且在长期治疗期间会出现对镇静和警觉性降低的耐受性。抗精神病药物有增强酒精、镇静催眠药、麻醉药和抗组胺药作用的能力；因此，抗精神病药物与这些物质合用会增加对驾驶行为的损害。有迹象表明，镇静作用较小的哌嗪类吩噻嗪和丁酰苯类药物可能对精神运动性能几乎没有影响，这两个亚类的抗精神病药物至少在驾驶性能方面可能比其他更具镇静作用的药物有明显优势。抗精神病药物几乎从不用于娱乐或滥用目的；因此，本综述的重点更在于抗精神病药物可能对那些需要持续服用这些药物进行维持治疗的严重精神疾病患者的驾驶行为产生的影响。文献中对此有很好的共识，即精神分裂症患者在使用抗精神病药物进行长期治疗期间精神运动性能有所改善。（摘要截取自250词）
