Department of Clinical and Developmental Neuropsychology, University of Groningen, Groningen, The Netherlands.
Division of Pharmacology, Utrecht University, Utrecht, The Netherlands.
Traffic Inj Prev. 2024;25(7):902-911. doi: 10.1080/15389588.2024.2358093. Epub 2024 Jul 12.
Using benzodiazepines and certain antidepressants is associated with an increased risk of motor vehicle crashes due to impaired driving skills. Hence, several countries prohibit people who use these drugs from driving. Traffic regulations for driving under the influence of these drugs are, however, largely based on single-dose studies with healthy participants. The effects of drugs on chronic users may be different because of potential development of tolerance or by adapting behavior. In this study, we test the effects of anti-depressants, hypnotics, or anxiolytics use on driving performance in patients who use these drugs for different durations and compare the effects to healthy controls' performance.
Sixty-six healthy controls and 82 medication users were recruited to perform four drives in a driving simulator. Patients were divided into groups that used anti-depressants, hypnotics, or anxiolytics, for shorter or longer than 3 years (i.e. LT3- or LT3+, respectively). The minimum term of use was 6 months. Driving behavior was measured in terms of longitudinal and lateral control (speed variability and Standard Deviation of Lateral Position: SDLP), brake reaction time, and time headway. Impaired driving performance was defined as performing similar to driving with a Blood Alcohol Concentration of 0.5‰ or higher, determined by means of non-inferiority analyses.
Reaction time analyses revealed inconclusive findings in all groups. No significant performance differences between matched healthy controls, LT3- ( = 2), and LT3+ ( = 8) anxiolytics users were found. LT3+ antidepressants users ( = 12) did not perform inferior to their matched controls in terms of SDLP. LT3- hypnotics users ( = 6) showed more speed variability than their matched healthy controls, while this effect was not found for the LT3+ group ( = 14): the latter did not perform inferior to the healthy controls. Regarding Time Headway, no conclusions about the LT3- hypnotics group could be drawn, while the LT3+ group did not perform inferior compared to the control group.
The small number of anxiolytics users prohibits drawing conclusions about clinical relevance. Although many outcomes were inconclusive, there is evidence that some elements of complex driving performance may not be impaired (anymore) after using antidepressants or hypnotics longer than 3 years.
使用苯二氮䓬类药物和某些抗抑郁药会因驾驶技能受损而增加发生机动车事故的风险。因此，有几个国家禁止使用这些药物的人开车。然而，这些药物的交通法规主要基于健康参与者的单次剂量研究。由于潜在的耐受性发展或行为适应，药物对慢性使用者的影响可能会有所不同。在这项研究中，我们测试了抗抑郁药、催眠药或抗焦虑药在使用这些药物不同时间的患者的驾驶表现上的影响，并将其与健康对照者的表现进行了比较。
招募了 66 名健康对照者和 82 名药物使用者在驾驶模拟器中进行四次驾驶。患者分为使用抗抑郁药、催眠药或抗焦虑药时间较短（LT3-组）或较长（LT3+组）的组，分别为 3 年或 3 年以上。最短使用期限为 6 个月。驾驶行为的测量指标包括纵向和横向控制（速度变异性和横向位置标准差：SDLP）、制动反应时间和车头时距。驾驶表现受损定义为表现类似于血液酒精浓度为 0.5‰或更高，通过非劣效性分析来确定。
反应时间分析在所有组中均未得出明确结论。在 LT3-（ = 2）和 LT3+（ = 8）抗焦虑药物使用者中，未发现与匹配的健康对照组之间存在显著的性能差异。LT3+抗抑郁药物使用者（ = 12）在 SDLP 方面与匹配的对照组表现相当。LT3-催眠药物使用者（ = 6）的速度变异性高于其匹配的健康对照组，而 LT3+组（ = 14）则没有发现这种效果：后者与健康对照组的表现相当。关于车头时距，对于 LT3-催眠药物组无法得出结论，而 LT3+组与对照组相比并未表现出劣势。
抗焦虑药物使用者数量较少，无法得出临床相关性的结论。尽管许多结果不确定，但有证据表明，使用抗抑郁药或催眠药 3 年以上后，某些复杂驾驶性能的元素可能不会受损（或不再受损）。
