Effect of tricyclic antidepressants and alcohol on psychomotor skills related to driving

Seppälä, Mika; Linnoila, Markku; Elonen, Erkki; Mattila, Mauri J.; Maki, M

doi:10.1002/cpt1975175515

Cited by 56 publications

(19 citation statements)

References 6 publications

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“…Although there are no previous studies reported which are directly comparable with the present one, our results are broadly compatible with the findings of Seppala et al (1975) and Seppala (1977). These workers used lower doses of amitriptyline but the subjects were studied during 2 weeks of treatment.…”

Section: Total Choice Reaction Time (Crt; Figure 2)supporting

confidence: 93%

“…Patients tend to become tolerant to the sedative effects of drugs during chronic treatment, and it could be argued that the adverse effects of ethanol on psychomotor performance might be more serious and more easily detected when examined on a background of only minor drug-related sedation. In fact, the available evidence suggests that the impairment of performance by both antidepressant and ethanol diminishes during the course of a few weeks' treatment with the drugs Seppala et al, 1975;Seppala, 1977 …”

Section: Total Choice Reaction Time (Crt; Figure 2)mentioning

confidence: 99%

“…There is evidence that this is so in the case of amitriptyline Patman et al, 1969;Seppaila et al, 1975;Seppala, 1977), doxepin (Seppala et al, 1975) and mianserin (Seppala, 1977) but not for chlorimipramine, nortriptyline (Seppala et al, 1975), nomifensine (Taeuber, 1977) or zimelidine (Scott et al, 1982).…”

Section: Introductionmentioning

confidence: 99%

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An evaluation of possible interactions between ethanol and trazodone or amitriptyline.

Warrington¹,

Ankier²,

Turner³

1984

Brit J Clinical Pharma

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The pharmacodynamic effects of single doses of trazodone (100 mg), amitriptyline (50 mg) or placebo either alone or with ethanol (0.5 ml/kg) were investigated in six healthy volunteers in a double‐blind crossover study. Plasma concentrations of the drugs and ethanol were also measured. Pharmacodynamic tests were critical flicker fusion frequency threshold (CFF), choice reaction time (CRT), manual dexterity, a digit span test and visual analogue scales. Blood ethanol concentrations were not influenced by the co‐administration of either antidepressant. tmax for trazodone was prolonged by ethanol but the other pharmacokinetic parameters for trazodone and amitriptyline were not influenced by ethanol. Trazodone and amitriptyline caused the expected profound depressant effects on CFF, CRT, manual dexterity and on the rating scales for drowsiness, ‘clear‐headedness’, aggression and disinhibition. Ethanol alone impaired manual dexterity, increased drowsiness, reduced ‘clear headedness’ and also tended to reduce feelings of aggression. In combination with either trazodone or amitriptyline, ethanol caused little additional effect except in the case of manual dexterity which was further impaired. This result may reflect the profound effects of the antidepressants alone and does not suggest that it is safe for patients receiving antidepressant medication to take ethanolic drinks.

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Section: Total Choice Reaction Time (Crt; Figure 2)supporting

confidence: 93%

Section: Total Choice Reaction Time (Crt; Figure 2)mentioning

confidence: 99%

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An evaluation of possible interactions between ethanol and trazodone or amitriptyline.

Warrington¹,

Ankier²,

Turner³

1984

Brit J Clinical Pharma

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“…While studies of the interaction of alcohol with benzodiazepines are common (and often arrive at different conclusions), the interaction of alcohol with antidepressants has been studied tess frequentIjy: The effect of tricyclic antidepressants and alcohol on psychomotor skills related to driving was examined by Seppala et al (1975). While the individual drugs failed to impair the psychomotor skills combination of alcohol with amitriptyline and with doxepin impaired performance in cumulative choice reaction times and the latter drug also increased errors in reaction time.…”

Section: Discussionmentioning

confidence: 99%

The effect of bupropion, a new antidepressant drug, and alcohol and their interaction in man

Hamilton

Bush

Peck

1984

Eur J Clin Pharmacol

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The effects of bupropion and ethanol were examined alone and in combination in a placebo controlled, double-blind, crossover study in 12 healthy volunteers. Results were subjected to analysis of variance and differences of p less than 0.05 taken as significant. In the main study using the Wilkinson auditory vigilance test, no active treatment or combination of treatments produced significant change compared with placebo. However, when compared with bupropion 100 mg, vigilance was significantly impaired by 32 ml alcohol alone though not when combined with bupropion. No significant changes in reaction time or short term memory occurred. Visual analogue scales indicated that the subjects were mentally slower after alcohol 32 ml than after placebo. Combination of bupropion 100 mg with alcohol 32 ml abolished this difference. A similar pattern occurred with group ratings indicating mental sedation. Subjects were clearly able to differentiate between the 16 ml and 32 ml doses of alcohol when assessing their degree of inebriation. Combination of bupropion with alcohol made no difference to the ratings of inebriation. The top dose of alcohol tended to increase energy in the low frequency EEG bands. Combination of the top alcohol dose with bupropion, however, produced a significant reversal with lowered energy in the 4-7.5 Hz band. Combination of bupropion with alcohol failed to change the blood alcohol concentration achieved.

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“…12 Several studies have shown that alcohol potentiates the sedative effects of TCA. 13,14 The aim of the present study was to investigate whether milnacipran has any influence on neurosensory vigilance during car driving.…”

Section: Introductionmentioning

confidence: 99%

Effects of milnacipran on driving vigilance

Richet¹,

Marais²,

Serre

et al. 2004

International Journal of Psychiatry in Clinical Practice

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BACKGROUND Many psychotropic drugs modify sensory and/or psychomotor functions involved in car driving and as such they can be a causative factor in road accidents. AIM To investigate the effects of the administration of milnacipran, a serotonin and noradrenaline dual-action antidepressant, on the sensory and psychomotor skills implicated in car driving and to determine any possible interactions with the effect of alcohol. METHODS Double-blind, placebo-controlled four-sequence cross-over design with 12 healthy volunteers. Laboratory tests designed to explore motor responses to auditory and visual stimuli and equilibrium on a sensory platform, as well as tests in a real on-road car driving situation, were carried out before the drug administration (control) and at the end of each sequence. RESULTS There was no significant difference in the results of laboratory tests between groups receiving milnacipran compared to placebo. In a real driving situation there were no significant effects of milnacipran. In addition, milnacipran did not accentuate the negative effects of alcohol. CONCLUSIONS Milnacipran, administered at 50 mg b.i.d. to healthy volunteers, does not modify the psychomotor skills required for driving.

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Effect of tricyclic antidepressants and alcohol on psychomotor skills related to driving

Cited by 56 publications

References 6 publications

An evaluation of possible interactions between ethanol and trazodone or amitriptyline.

An evaluation of possible interactions between ethanol and trazodone or amitriptyline.

The effect of bupropion, a new antidepressant drug, and alcohol and their interaction in man

Effects of milnacipran on driving vigilance

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