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Risk of Injurious Road Traffic Crash After Prescription of Antidepressants [CME]

J Clin Psychiatry 2012;73(8):1088-1094
10.4088/JCP.11m07624

Objective: To estimate the risk of road traffic crash associated with prescription of antidepressants.

Method: Data were extracted and matched from 3 French national databases: the national health care insurance database, police reports, and the national police database of injurious crashes. A case-control analysis comparing 34,896 responsible versus 37,789 nonresponsible drivers was conducted. Case-crossover analysis was performed to investigate the acute effect of medicine exposure.

Results: 72,685 drivers, identified by their national health care number, involved in an injurious crash in France from July 2005 to May 2008 were included. 2,936 drivers (4.0%) were exposed to at least 1 antidepressant on the day of the crash. The results showed a significant association between the risk of being responsible for a crash and prescription of antidepressants (odds ratio [OR]=1.34; 95% CI, 1.22–1.47). The case-crossover analysis showed no association with treatment prescription, but the risk of road traffic crash increased after an initiation of antidepressant treatment (OR=1.49; 95% CI, 1.24–1.79) and after a change in antidepressant treatment (OR=1.32; 95% CI, 1.09–1.60).

Conclusions: Patients and prescribers should be warned about the risk of crash during periods of treatment with antidepressant medication and about particularly high vulnerability periods such as those when a treatment is initiated or modified.

J Clin Psychiatry 2012;73(8):1088–1094

Submitted: December 29, 2011; accepted April 18, 2012 (doi:10.4088/JCP.11m07624).

Corresponding author: Ludivine Orriols, PhD, Equipe Prévention et Prise en Charge des Traumatismes, Centre de Recherche INSERM U897 “Epidémiologie et Biostatistiques” Université Bordeaux Segalen, Case 11, 146 rue Léo Saignat, 33076 Bordeaux Cedex, France (ludivine.orriols@isped.u-bordeaux2.fr).