Minor Increase in Risk of Road Traffic Accidents After Prescriptions of Antidepressants: A Study of Population Registry Data in Norway
J Clin Psychiatry 2008;69(7):1099-1103
© Copyright 2014 Physicians Postgraduate Press, Inc.
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Objectives: Experimental studies have shown
that both depression and the use of antidepressants
may impair the ability to drive a motor vehicle.
Population-based studies have been inconclusive. Differences
in results have been shown for cyclic, sedating
antidepressants and newer, nonsedating antidepressants.
The objective of the present study was to examine
whether the use of antidepressants by drivers increased the
risk of being involved in traffic accidents.
Method: From April 2004 to September 2006,
information on prescriptions, road accidents, and
emigrations/deaths was obtained from 3 Norwegian
population-based registries. Data on people between the
ages 18-69 (N = 3.1 million) were linked. Exposure
consisted of receiving prescriptions for any antidepressants. Standardized incidence ratios (SIRs)
were calculated by comparing the incidence of
accidents during time exposed with the incidence over the
time not exposed. Sedating antidepressants (tricyclic
antidepressants, mianserin, and mirtazapine) were
studied together as one group, and newer, nonsedating
antidepressants (selective serotonin reuptake
inhibitors, moclobemide, venlafaxine, and reboxetine) as another.
Results: During the study period, 20,494 road
accidents with personal injuries occurred, including
204 and 884 in which the driver was exposed to
sedating antidepressants or newer, nonsedating
antidepressants, respectively. The traffic accident risk increased
slightly for drivers who had received prescriptions for
sedating antidepressants (SIR = 1.4, 95% CI = 1.2 to 1.6)
or nonsedating antidepressants (SIR = 1.6, 95% CI =
1.5 to 1.7). The SIR estimates were similar for male
and female drivers and slightly higher for young
drivers (18-34 years of age) using older sedative
antidepressants. SIR estimates did not change substantially
for different time periods after dispensing of the
prescription, for concomitant use of other impairing drugs,
or for new users.
Conclusion: There was a slightly increased risk
of being involved in a traffic accident after having
received a prescription for any antidepressants. In
the present study, it was not possible to determine
whether this increase was due to the antidepressant, the effect
of the depression, or characteristics of the patients
being prescribed these drugs.