Risk of Injurious Road Traffic Crash After Prescription of Antidepressants

Orriols, Ludivine; Queinec, Raphaëlle; Philip, Pierre; Gadegbeku, Blandine; Delorme, Bernard; Moore, Nicholas; Suissa, Samy; Lagarde, Emmanuel

doi:10.4088/jcp.11m07624

Cited by 39 publications

(33 citation statements)

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“…The stratified case–control analysis showed similar results in both subgroups . A recent case–crossover study showed that the risk of crash was increased in users who initiated an antidepressant treatment and a case–control analysis showed an increased risk of responsibility in the crash for all antidepressant users . Risk estimates in case–control studies are a combination of the effect of medicines in regular users, the effect of medicines in occasional users and the effect of depression symptoms.…”

Section: Introductionmentioning

confidence: 62%

Prescription of antidepressants and the risk of road traffic crash in the elderly: a case–crossover study

Orriols

Wilchesky

Lagarde

et al. 2013

Brit J Clinical Pharma

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AIMTo investigate the impact of antidepressants on the risk of road traffic crash in the elderly. METHODSReports from the Universal Quebec Automobile Insurance Agency database were matched with data on antidepressant prescription from the Quebec Health Insurance Agency. The case-crossover analysis consisted in comparing exposure during a period immediately before the crash with exposure during earlier periods, for the same subject. RESULTSOne hundred and nine thousand four hundred and six drivers between 66 and 84 years of age involved in a traffic crash between 1988 and 2000 were included. Two thousand nine hundred and nineteen (2.7%) were exposed to an antidepressant on the day of the crash. Case-crossover analysis found an increased risk of crash in drivers with a prescription of antidepressants before their crash when compared with a prescription of antidepressants 4 to 8 months before the crash (OR = 1.19, 95% CI 1.08, 1.30 to 1.42. 95% CI 1.30, 1.55). With the most recent control periods, results were not significant.

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Section: Introductionmentioning

confidence: 62%

Prescription of antidepressants and the risk of road traffic crash in the elderly: a case–crossover study

Orriols

Wilchesky

Lagarde

et al. 2013

Brit J Clinical Pharma

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“…Depression was not assessed. Orriols et al (Orriols et al 2012) did a case-crossover analysis of 72,685 drivers in France using the national health care insurance database and the national police database and found an OR of 1.34 for crash and prescription of antidepressants as a class (95% CI, 1.22 to 1.47). SSRIs (OR = 1.30; 95% CI, 1.16 to 1.46), SNRIs (OR = 1.51; 95% CI, 1.25 to 1.84), and other antidepressants (OR = 1.30; 95% CI, 1.01 to 1.67) also had a significant association with increased risk of crash.…”

Section: Resultsmentioning

confidence: 99%

“…al (LeRoy & Morse 2008), Ravera et.al (Ravera et al 2011), Sagberg et.al (Sagberg 2006), Orriols et. al (Orriols et al 2012)) were included in the quantitative meta-analysis on antidepressant use and crash risk (Table 2). Two studies (Bramness et.…”

Section: Resultsmentioning

confidence: 99%

Depression, antidepressants and driving safety

Hill¹,

Lauzon²,

Winbrock³

et al. 2017

Inj. Epidemiol.

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BackgroundThe purpose of this study was to review the reported associations of depression and antidepressants with motor vehicle crashes.PurposeA literature search for material published in the English language between January, 1995, and October, 2015, in bibliographic databases was combined with a search for other relevant material referenced in the retrieved articles.MethodsRetrieved articles were systematically reviewed for inclusion criteria: 19 epidemiological studies (17 case-control and 2 cohort studies) fulfilled the inclusion criteria by estimating the crash risk associated with depression and/or psychotropic medications in naturalistic settings.ResultsThe estimates of the odds ratio (OR) of crash involvement associated with depression ranged from 1.78 to 3.99. All classes of antidepressants were reported to have side effects with the potential to affect driving safety. The majority of studies of antidepressant effects on driving reported an elevated crash risk, and ORs ranged from 1.19 to 2.03 for all crashes, and 3.19 for fatal crashes. In meta-analysis, depression was associated with approximately 2-fold increased crash risk (summary OR = 1.90; 95% CI, 1.06 to 3.39), and antidepressants were associated with approximately 40% increased crash risk (summary OR = 1.40; 95%CI, 1.18 to 1.66).ConclusionBased on the findings of the studies reviewed, depression, antidepressants or the combination of depression and antidepressants may pose a potential hazard to driving safety. More research is needed to understand the individual contributions of depression and the medications used to treat depression.

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“…The association between drivers’ use of benzodiazepines and the risk of road crash is now consistently documented [9–14]. Other medicines have also been studied: antidepressants [10,13–17], opioids used in pain treatment and in substitution treatment for opioid dependence [11,13,18,19], and cardiovascular drugs [20,21]. A positive association was found in these studies, except for 1 study [20] that found no association between calcium channel blockers and the risk of crash, and 2 studies [11,19] in which there was an increased risk with opioid use, but the increase was not statistically significant.…”

Section: Introductionmentioning

confidence: 99%

Prescription medicine use by pedestrians and the risk of injurious road traffic crashes: A case-crossover study

et al. 2017

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BackgroundWhile some medicinal drugs have been found to affect driving ability, no study has investigated whether a relationship exists between these medicines and crashes involving pedestrians. The aim of this study was to explore the association between the use of medicinal drugs and the risk of being involved in a road traffic crash as a pedestrian.Methods and findingsData from 3 French nationwide databases were matched. We used the case-crossover design to control for time-invariant factors by using each case as its own control. To perform multivariable analysis and limit false-positive results, we implemented a bootstrap version of Lasso. To avoid the effect of unmeasured time-varying factors, we varied the length of the washout period from 30 to 119 days before the crash. The matching procedure led to the inclusion of 16,458 pedestrians involved in an injurious road traffic crash from 1 July 2005 to 31 December 2011. We found 48 medicine classes with a positive association with the risk of crash, with median odds ratios ranging from 1.12 to 2.98. Among these, benzodiazepines and benzodiazepine-related drugs, antihistamines, and anti-inflammatory and antirheumatic drugs were among the 10 medicines most consumed by the 16,458 pedestrians. Study limitations included slight overrepresentation of pedestrians injured in more severe crashes, lack of information about self-medication and the use of over-the-counter drugs, and lack of data on amount of walking.ConclusionsTherapeutic classes already identified as impacting the ability to drive, such as benzodiazepines and antihistamines, are also associated with an increased risk of pedestrians being involved in a road traffic crash. This study on pedestrians highlights the necessity of improving awareness of the effect of these medicines on this category of road user.

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Risk of Injurious Road Traffic Crash After Prescription of Antidepressants

Abstract: 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.

Cited by 39 publications

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Prescription of antidepressants and the risk of road traffic crash in the elderly: a case–crossover study

Prescription of antidepressants and the risk of road traffic crash in the elderly: a case–crossover study

Depression, antidepressants and driving safety

Prescription medicine use by pedestrians and the risk of injurious road traffic crashes: A case-crossover study

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