Driving ability in schizophrenic patients: effects of neuroleptics

Abstract

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.

Simulated car driving and its association with cognitive abilities in patients with schizophrenia

“…This discrepancy might be explained by the motor impairments of the patients with schizophrenia in the study of Wylie et al (1993), as the authors put parkinsonian motor impairments forward as the likely main mechanism by which antipsychotic medications may impair driving and report a significant correlation between parkinsonism and brake reaction times in their trial sessions. Motor impairments may have been less pronounced in the present sample of patients with schizophrenia because of the use of atypical antipsychotic medications (Gallhofer et al, 1996;Kagerer et al, 2003;Soyka et al, 2005). The finding that patients with schizophrenia showed less swerving in the hurry condition than healthy participants also contrasts with the findings of previous studies in which lane tracking was compromised in patients with schizophrenia (St. Germain et al, 2005;Wylie et al, 1993).…”

“…An alternative explanation would be that patients with schizophrenia drive slower to compensate for and adapt to cognitive impairments (Fuller, 2005), although this was not sufficient to normalize their driving performance (St. Germain et al, 2005). Moreover, antipsychotic medications may impair psychomotor functions and driving performance of patients with schizophrenia (Brunnauer et al, 2009;Kagerer et al, 2003;Soyka et al, 2005;Wylie et al, 1993).…”

Étude rétrospective d'une pratique d'évaluation de la conduite automobile en santé mentale adulte

“…Aussi, les déficits cognitifs découlant des différents diagnostics psychiatriques sont nombreux et variés (Farmer et coll., 2000;Green, Kern, Braff et Mintz, 2000;Harris, 2000). Il est maintenant confirmé par des études récentes que la performance d'une majorité de personnes ayant un diagnostic de schizophrénie, lors d'épreuves cognitives, ne rencontre pas les exigences minimales requises pour la conduite automobile (Soyka, Kagerer, Brunnauer, Laux et Möller, 2005;Soyka et Winter, 2005). Enfin, d'autres travaux (Elander, West et French, 1993) indiquent que certains traits de personnalités (impulsivité, intolérance face à une figure d'autorité, tendance paranoïaque) sont associés à un risque accru d'accidents.…”