Effects of depot neuroleptics on driving performance in chronic schizophrenic patients.

Wylie, Kevan; Thompson, Diane; Wildgust, Hiram J

doi:10.1136/jnnp.56.8.910

Cited by 20 publications

(13 citation statements)

References 14 publications

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“…Likewise, it would be important to explore differences between cases and controls in relation to driving patterns, driving experience, co-morbidities, risk taking behaviours, weather conditions and vehicle types, etc. Lastly, unlike most previous investigations that focused on driving performance under pharmacologic treatment in hospital-based populations, this study was conducted in a general population [38][39][40]. In Motor vehicle accidents and psychotropic drugs addition, we did not investigate the role of polypharmacy in this study population.…”

Section: Discussionmentioning

confidence: 99%

Psychotropic drugs and risk of motor vehicle accidents: a population‐based case‐control study

Chang

Chen³

et al. 2013

Brit J Clinical Pharma

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AIMTo examine comprehensively the relationship between exposure to four classes of psychotropic drugs including antipsychotics, antidepressants, benzodiazepines (BZDs) and Z-drugs, and motor vehicle accidents (MVAs). METHODThe authors conducted a matched case-control study of 5183 subjects with MVAs and 31 093 matched controls, identified from the claims records of outpatient service visits during the period from 2000 to 2009. Inclusion criteria were defined as subjects aged equal to or more than 18 years and involved in MVAs. Conditional logistic regressions with covariates adjustment (including urbanity, psychiatric and non-psychiatric outpatient visits and Charlson comorbidity score) were applied to examine the effect of four classes of psychotropic drugs on MVAs. RESULTSSignificant increased risk of MVAs was found in subjects taking antidepressants within 1 month (adjusted odds ratio (AOR) 1.73, 95% confidence interval (CI) 1.34, 2.22), 1 week (AOR 1.71, 95% CI 1.29, 2.26), and 1 day (AOR 1.70, 95% CI 1.26, 2.29) before MVAs occurred. Similar results were observed in subjects taking benzodiazepines (BZDs) (AOR 1.56, 95% CI 1.38, 1.75 for 1 month; AOR 1.64, 95% CI 1.43, 1.88 for 1 week, and AOR 1.62, 95% CI 1.39, 1.88 for 1 day) and Z-drugs (AOR 1.42, 95% CI 1.14, 1.76 for 1 month, AOR 1.37, 95% CI 1.06, 1.75 for 1 week, AOR 1.34, 95% CI 1.03, 1.75 for 1 day), but not antipsychotics. Moreover, significant dose effects of antidepressants (equal to or more than 0.6-1.0 DDD), BZDs (equal to or more than 0.1-0.5 DDD) and Z-drugs (more than 1 DDD) were observed, respectively, on the risk of experiencing an MVA. CONCLUSIONTaken together, subjects taking antidepressants, BZDs and Z-drugs, separately, should be particularly cautioned for their increasing risk of MVAs. WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT• It has long been known that psychotropic drugs impair cognitive and psychomotor abilities.• Most studies have mainly focused on the relationship between benzodiazepines (BZDs) and motor vehicle accidents (MVAs). Limited information is available regarding an assessment of the effect of the new classes of psychotropic drugs on MVAs. WHAT THIS STUDY ADDS• In addition to BZDs (including long acting, short acting, hypnotic and anxiolytic), exposure to antidepressants (SSRIs and TCAs) and Z-drugs was significantly associated with an increased risk of MVAs.• The findings underscore that subjects taking these psychotropic medications should pay increased attention to their driving performance in order to prevent the occurrence of MVAs.

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Section: Discussionmentioning

confidence: 99%

Psychotropic drugs and risk of motor vehicle accidents: a population‐based case‐control study

Chang

Chen³

et al. 2013

Brit J Clinical Pharma

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“…Wylie et al [45] studied 22 chronic schizophrenic patients receiving flupenthixol decanoate or fluphenazine decanoate matched to 16 controls. Psychomotor tasks were assessed using special computer software, including a stimulated driving task.…”

Section: Clinical and Experimental Studiesmentioning

confidence: 98%

Driving ability in schizophrenic patients: effects of neuroleptics

Soyka¹,

Kagerer²,

Brunnauer³

et al. 2005

International Journal of Psychiatry in Clinical Practice

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Recent studies indicate that individuals with schizophrenia have a two-fold incidence of traffic accidents. Cognitive and psychomotor impairment as a core feature of schizophrenia and the effects of neuroleptic treatment play an essential role in this respect. Few experimental studies have been conducted so far looking at the effects of neuroleptics on driving ability in schizophrenia. Controlled, randomised trials are totally missing. The limited database indicates that most schizophrenic patients show significant impairment in cognitive functions relevant for driving ability compared to healthy controls. There is some but limited evidence that patients under novel atypical neuroleptics show less impairment compared to conventional neuroleptics. More clinical and experimental studies are warranted.

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“…There are currently 36 types of confirmed DS . As each research group uses a DS for a specific purpose, there is no unified scenario (e.g., highway, urban roads).…”

Section: Resultsmentioning

confidence: 99%

“…In total, 121 papers were classified as involving: actual vehicle tests for healthy subjects (Table ), DS experiments for healthy subjects (Table ), actual vehicle experiments and DS experiments for patients (Table ), and experiments using ART‐90. Twenty‐seven out of 121 studies targeted patients using real vehicles and DS.…”

Section: Resultsmentioning

confidence: 99%

Evaluation method regarding the effect of psychotropic drugs on driving performance: A literature review

Iwata

Iwamoto

Kawano

et al. 2018

Psychiatry Clin Neurosci

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Although automobile driving is necessary for many people, including patients with mental disorders, the influence of psychotropic drugs on driving performance remains unclear and requires scientific verification. Therefore, the objective of this study was to conduct a review of the literature in order to aid the development of a valid evaluation method regarding the influence of medication on driving performance. We conducted a literature search using two sets of terms on PubMed. One set was related to psychotropic drugs, and the other to driving tests. We excluded reviews and case studies and added literature found on other sites. A total of 121 relevant reports were found. The experiments were roughly divided into on-the-road tests (ORT) and driving simulators (DS). Although highway driving tests in ORT are most often used to evaluate driving performance, DS are becoming increasingly common because of their safety and low cost. The validity of evaluation methods for alcohol should be verified; however, we found that there were few validated tests, especially for DS. The scenarios and measurement indices of each DS were different, which makes it difficult to compare the results of DS studies directly. No evaluation indices, except for SD of lateral position, were sufficiently validated. Although highway ORT are the gold standard, DS were shown to have an increasing role in evaluating driving performance. The reliability of DS needs to be established, as does their validation with alcohol in order to accumulate more high-quality evidence.

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Effects of depot neuroleptics on driving performance in chronic schizophrenic patients.

Cited by 20 publications

References 14 publications

Psychotropic drugs and risk of motor vehicle accidents: a population‐based case‐control study

Psychotropic drugs and risk of motor vehicle accidents: a population‐based case‐control study

Driving ability in schizophrenic patients: effects of neuroleptics

Evaluation method regarding the effect of psychotropic drugs on driving performance: A literature review

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