Driving performance and neurocognitive skills of long‐term users of benzodiazepine anxiolytics and hypnotics

Abstract

Objective The aim of this study is to compare actual driving performance and skills related to driving of patients using benzodiazepine anxiolytics or hypnotics for at least 6 months to that of healthy controls. Methods Participants were 44 long‐term users of benzodiazepine and benzodiazepine‐related anxiolytics (n = 12) and hypnotics (n = 32) and 65 matched healthy controls. Performance was assessed using an on‐the‐road driving test measuring standard deviation of lateral position (SDLP, in cm) and a battery of neurocognitive tasks. Performance differences between groups were compared with a blood alcohol concentration of 0.5 mg/ml to determine clinical relevance. Results Compared with controls, SDLP was significantly increased in hypnotic users (+1.70 cm) but not in anxiolytic users (+1.48 cm). Anxiolytic and hypnotic users showed significant and clinically relevant impairment on neurocognitive task measuring executive functioning, vigilance, and reaction time. For patients using hypnotics for at least 3 years, no significant driving impairment was observed. Conclusion Impairing effects of benzodiazepine hypnotics on driving performance may mitigate over time following longer term use (i.e. 3 years or more) although neurocognitive impairments may remain.

An explorative approach to understanding individual differences in driving performance and neurocognition in long‐term benzodiazepine users

“…A recent study by van der Sluiszen et al. ( 2019 ) on neurocognitive and driving performance of long‐term (≥6 months) BZRA users found that this group exhibited significant impairments on tasks of vigilance, executive functioning, and reaction speed. In line with these findings, a meta‐analysis by Barker, Greenwood, Jackson, and Crowe ( 2004a ) reported that long‐term BZRA users (≥1 year) are impaired on neuropsychological tests of attention, problem solving, visuospatial cognition, general intelligence, psychomotor speed, and nonverbal memory.…”

On-the-road driving performance of patients with central disorders of hypersomnolence

“…Thirty-one healthy subjects (20 male, 11 female) formed a control group. Their data were retrieved from a normative dataset collected in a previous study using the same driving test and procedures (Van der Sluiszen et al 2019). Control subjects had a valid driving license for at least 3 years and drove at least 3000 km per year.…”

“…Adequate alertness is crucial for safely operating a vehicle. Several studies have shown that sleepiness while driving is one of the major causes of car accidents (Sagberg et al 2004;Higgins et al 2017). Severe daytime sleepiness is the most common and disturbing complaint of patients with narcolepsy and idiopathic hypersomnia (IH).…”

“…Patients with NT1, NT2 or IH presenting to sleep clinics for the evaluation of their fitness to drive to allow continuation of their license were invited for this study. Their performance was assessed using a standardized highway driving test (O'Hanlon 1984;Ramaekers 2017) and compared to that of a normative group of healthy controls who completed the same test, using identical procedures, equipment and test environment (Van der Sluiszen et al 2019).…”

Side effects of psychotropic drugs on eye

“…Анксиолитики могут вызывать дозозависимые двигательные нарушения глаз; приема данных препаратов следует по возможности избегать во время вождения автомобиля [17], особенно в сочетании с алкоголем или другими антидепрессантами [4]. По данным U. Ettinger et al, лоразе-Обзоры пам приводит к снижению амплитуды саккад и их пиковой скорости, при этом он увеличивает длительность саккад и значимо не влияет на их среднюю скорость [18].…”