Zolpidem and zopiclone impair similarly monotonous driving performance after a single nighttime intake in aged subjects

Bocca, Marie‐Laure; Marie, Sullivan; Lelong‐Boulouard, Véronique; Bertran, Françoise; Couque, Colette; Desfemmes, Tsellina; Berthelon, Catherine; Amato, Jean-Noël; Moessinger, Michèle; Paillet-Loilier, Magalie; Coquerel, Antoine; Denise, Pierre

doi:10.1007/s00213-010-2075-5

Cited by 41 publications

(34 citation statements)

References 40 publications

(49 reference statements)

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“…This result is in accordance with former randomized studies demonstrating more pronounced effects due to higher dosages of zopiclone, compared with that of lower dosages [16,21,[26][27][28][29]. A recent study supports a hypothesis that the SFST is also able to identify impairment associated with the use of CNS stimulants, CNS depressants, cannabis, and narcotic analgetics [30].…”

Section: Discussionsupporting

confidence: 92%

“…The SCTI failed to detect major impairment 7 h after drug intake, while the CPTI was able to reveal impairment at this time, both for zopiclone and for alcohol. This result is in accordance with previous studies, revealing impairment due to similar dosages of zopiclone, at 7.5 h after intake [20], and at more than 10 h after intake [21][22][23]. A recent study compared the outcomes of various psychometric tests with measurements of the standard deviation of the lateral position (SDLP), while driving a car in an experimental situation [24].…”

Section: Discussionsupporting

confidence: 88%

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Can a simple clinical test detect impairment of zopiclone and alcohol? – A randomized controlled trial

Hjelmeland

Gustavsen

Bernard

et al. 2015

Forensic Science International

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The SCTI may be a useful tool, especially during roadside investigation, when the police are in doubt as to whether the apprehended driver is impaired or not. A subject, who has consumed zopiclone or alcohol, tested with the SCTI, with one or more subtests diverging from a habitual result, is likely to have a blood zopiclone concentration above 23ng/ml or a BAC above 0.5g/l. A negative result, however, is less helpful.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 88%

Can a simple clinical test detect impairment of zopiclone and alcohol? – A randomized controlled trial

Hjelmeland

Gustavsen

Bernard

et al. 2015

Forensic Science International

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show abstract

“…For example, zolpidem use was associated with an inconsistent rate of speed, an increased number of lane departures in monotonous driving environment simulations and a modified lateral vehicle position in urban driving situations with accident scenarios. (Meskali et al 2009, Bocca et al 2011) Furthermore, it was not surprising that the strongest associations in the current study were among females and participants aged ≥ 80 years. Older adults and women have lower clearance rates and higher plasma concentrations for a given zolpidem dose compared to younger adults and men, respectively.…”

Section: Discussionmentioning

confidence: 53%

“…Intervention studies have detected clinically relevant elevated plasma concentrations of zolpidem the morning after taking zolpidem-containing medication. (Bocca et al 2011, Anon 2013c, a) As such, enduring drowsiness, loss of coordination and impaired alertness may contribute to the risk of MVCs. (Logan and Couper 2001, Hossain and Shapiro 2002) Additionally, well-controlled driving simulation studies provide evidence that zolpidem use is a risk factor for MVCs, even when recommended dosing was administered.…”

Section: Discussionmentioning

confidence: 99%

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Zolpidem use and motor vehicle collisions in older drivers

et al. 2016

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Background/Objectives Prescription sleep medication use is most prevalent among women and older adults. Morning drowsiness and impaired coordination are side-effects of sleep medications that may affect driving safety. The association between current use of zolpidem-containing medications and motor vehicle collisions (MVCs) was evaluated among very old drivers. Patients/Methods Participants were current drivers aged ≥70 years residing in north-central Alabama, spoke English, had a valid driver's license, and drove within the past 3 months (n=2,000). Current zolpidem use was determined by pill-bottle review. Participant's 5-year MVC history was determined from Alabama Department of Public Safety accident reports. The 5-year MVC and at-fault MVC rate ratios (RR) were estimated comparing zolpidem users with nonusers in the overall sample and a-priori defined age and sex subgroups. Results The unadjusted RR (95%CI) of MVCs comparing zolpidem users with nonusers was attenuated after adjustment (1.46 [1.02-2.08] and 1.38 [0.97-1.98], respectively). Among women, the unadjusted and adjusted RRs (95%CI) were 1.65 (1.03-2.66) and 1.61 (1.00-2.60), respectively. The unadjusted and adjusted RRs (95%CI) among those aged ≥80 years were 2.24 (1.19-4.57) and 2.35 (1.20-4.61), respectively. There were no statistically significant associations among men or participants <80 years old. Similar patterns were present for at-fault MVCs. Conclusion Current zolpidem users, specifically women and individuals aged ≥80 years, had higher MVC rates than nonusers. Practitioners should consider behavioral treatment before initiating low doses of zolpidem and escalating it as needed to achieve restorative sleep in females and individuals aged ≥80 years to reduce the risk of zolpidem-associated MVCs.

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Guideline for evaluating the effects of psychotropic drugs on motor vehicle driving performance in Japan: A tiered approach for the assessment of clinically meaningful driving impairment

Nakabayashi,

Iwamoto,

Yamaguchi

et al. 2024

Neuropsychopharm Rep

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In December 2022, the Ministry of Health, Labour and Welfare (MHLW) of Japan issued and implemented the guideline for evaluating the effects of psychotropic drugs on motor vehicle driving performance. This guideline recommends the use of a tiered approach to assess clinically meaningful driving impairment. It is noted that adverse events cannot be solely explained by pharmacokinetics, as the onset and duration of these events vary. Among these adverse events, those affecting alertness, such as drowsiness caused by psychotropic drugs on driving performance, are more frequently observed during initial treatment stages and dose escalation. Hence, when evaluating the effects of psychotropic drugs on driving performance, it becomes crucial to assess the persistence of clinically meaningful impairment. Therefore, the MHLW guideline, developed by the authors, emphasizes the need to assess the temporal profile of adverse events affecting driving in all clinical trials. Additionally, the guideline states that when conducting driving studies, the timing of multiple dosing should consider not only the pharmacokinetics of the investigational drug but also its tolerance.

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Zolpidem and zopiclone impair similarly monotonous driving performance after a single nighttime intake in aged subjects

Cited by 41 publications

References 40 publications

Can a simple clinical test detect impairment of zopiclone and alcohol? – A randomized controlled trial

Can a simple clinical test detect impairment of zopiclone and alcohol? – A randomized controlled trial

Zolpidem use and motor vehicle collisions in older drivers

Guideline for evaluating the effects of psychotropic drugs on motor vehicle driving performance in Japan: A tiered approach for the assessment of clinically meaningful driving impairment

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