Skip to main content Accessibility help
×
Home

Antidepressants and Driving in Older Adults: A Systematic Review

  • Duncan H. Cameron (a1) and Mark J. Rapoport (a1)

Abstract

With an increasing number of older drivers who are prescribed antidepressants, the potential consequences of antidepressant use on driving skills in an aging population are becoming a pressing issue. We conducted a systematic review using MEDLINE, targeting articles specifically pertaining to antidepressants and driving in a population or subgroup of older adults (≥ 55 years of age). The search yielded 267 references, nine of which pertained to the effects of antidepressants on driving in older adults. The single experimental study found imipramine to have detrimental effects on highway driving, whereas nefazodone did not. Seven of eight population-based studies reported a significant increased risk of involvement in a collision associated with antidepressant use. Although the studies indicated a negative effect of antidepressants on driving, the epidemiological designs cannot exclude the possibility that the underlying illness, generally major depression, is the culprit.

Avec le nombre croissant de conducteurs âgés pour lesquelles on prescrit des antidépresseurs, les conséquences potentielles de l’utilisation des antidépresseurs sur les compétences de conduite dans une population vieillissante deviennent un problème urgent. Nous avons effectué une analyse systématique en utilisant MEDLINE, ciblant des articles qui se rapportent spécifiquement aux antidépresseurs et à la conduite dans une population ou sous-groupe de personnes âgées (≥ 55 ans d’âge). La recherche a retourné 267 références, dont neuf portaient sur les effets des antidépresseurs sur la conduite chez les personnes âgées. L’étude expérimentale unique a trouvé que imipramine exerce des effets néfastes sur la conduite sur autoroute, alors que la néfazodone n’a pas fait. Sept des huit études de population ont rapporté une augmentation significative du risque d’être impliqué dans une collision associé à l’utilisation des antidépresseurs. Bien que les études ont indiqué un effet négatif des antidépresseurs sur la conduite, les conceptions épidémiologiques ne peuvent pas exclure la possibilité que la maladie sous-jacente, qui est généralement la dépression majeure, est la coupable.

  • View HTML
    • Send article to Kindle

      To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Antidepressants and Driving in Older Adults: A Systematic Review
      Available formats
      ×

      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

      Antidepressants and Driving in Older Adults: A Systematic Review
      Available formats
      ×

      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

      Antidepressants and Driving in Older Adults: A Systematic Review
      Available formats
      ×

Copyright

Corresponding author

*La correspondance et les demandes de tirés-à-part doivent être adressées à: / Correspondence and requests for offprints should be sent to: Mark J. Rapoport, M.D. FG37-2075 Bayview Ave. Toronto, ON M4N 3M5 (mark.rapoport@sunnybrook.ca)

References

Hide All
Brunnauer, A., & Laux, G. (2013). The effects of most commonly prescribed second generation antidepressants on driving ability: A systematic review: 70th Birthday Prof. Riederer. Journal of Neural Transmission, 120(1), 225232.
Bulmash, E. L., Moller, H. J., Kayumov, L., Shen, J., Wang, X., & Shapiro, C. M. (2006). Psychomotor disturbance in depression: assessment using a driving simulator paradigm. Journal of Affective Disorders, 93(1–3), 213218.
Centers for Disease Control and Prevention (CDC). (2012). National Center for Health Statistics (NCHS). National Health and Nutrition Examination Survey Data. Hyattsville, MD: U.S. Department of Health and Human Services.
Coupland, C., Dhiman, P., Morriss, R., Arthur, A., Barton, G., & Hippisley-Cox, J. (2011). Antidepressant use and risk of adverse outcomes in older people: Population based cohort study. BMJ, 343, d4551. doi:10.1136/bmj.d4551
Eby, D. W., Molnar, L. J., & Kartje, P. S. (2009). Maintaining safe mobility in an aging society. Boca Raton, FL: CRC Press.
Schulze, H., Schumacher, M., Urmeew, R., & Auerbach, K. (2012). Final Report: Work performed, main results and recommendations. DRUID (Driving under the Influence of Drugs, Alcohol and Medicines) Deliverable 0.1, 8. Retrieved from http://www.druid-project.eu/ (Accessed January 2015).
Fick, D., Semla, T., Beizer, J., Brandt, N., Dombrowski, R., BuBeau, , et al. (2012). American Geriatrics Society updated Beers Criteria for potentially inappropriate medication use in older adults. Journal of the American Geriatrics Society, 60(4), 616631.
Fuller, R. (2005). Towards a general theory of driver behaviour. Accident Analysis and Prevention, 37(3), 461472.
Gebara, M. A., Lipsey, K. L., Karp, J. F., Nash, M. C., Iaboni, A., & Lenze, E. J. (2015). Cause or effect? Selective serotonin reuptake inhibitors and falls in older adults: A systematic review. The American Journal of Geriatric Psychiatry, 23(10), 10161028.
Hale, A. S. (1994). The importance of accidents in evaluating the cost of SSRIs: A review. International Clinical Psychopharmacology, 9(3), 195201.
Hu, P. S., Trumble, D. A., Foley, D. J., Eberhard, J. W., & Wallace, R. B. (1998). Crash risks of older drivers: A panel data analysis. Accident Analysis and Prevention, 30(5), 569581.
Leveille, S. G., Buchner, D. M., Koepsell, T. D., McCloskey, L. W., Wolf, M. E., & Wagner, E. H. (1994). Psychoactive medications and injurious motor vehicle collisions involving older drivers. Epidemiology, 5(6), 591598.
Lyketsos, C. G., Lopez, O., Jones, B., Fitzpatrick, A. L., Breitner, J., & DeKosky, S. (2002). Prevalence of neuropsychiatric symptoms in dementia and mild cognitive impairment: results from the cardiovascular health study. Journal of the American Medical Association, 288(12), 14751483.
Meuleners, L. B., Duke, J., Lee, L. H., Palamara, P., Hildebrand, J., & Ng, J. Q. (2011). Psychoactive medications and crash involvement requiring hospitalization for older drivers: A population-based study. Journal of the American Geriatrics Society, 59(9), 15751580.
Michon, J. A. (1985). A critical view of driver behavior models: What do we know, what should we do? (pp. 485525). New York, NY: Springer.
Morimoto, S. S., & Alexopolous, G. S. (2013). Cognitive deficits in geriatric depression: Clinical correlates and implications for current and future treatment. Psychiatric Clinics of North America, 36(4), 517531.
National Highway Traffic Safety Administration. (2014). Traffic safety facts: A compilation of motor vehicle crash data from the Fatality Analysis Reporting System and the General Estimates System. Retrieved from http://www-nrd.nhtsa.dot.gov/Cats/listpublications.aspx?Id=E&ShowBy=DocType (Accessed January 2015).
Orriols, L., Queinec, R., Philip, P., Gadegbeku, B., Delorme, B., Moore, N., et al. (2012). Risk of injurious road traffic crash after prescription of antidepressants. Journal of Clinical Psychiatry, 73(8), 10881094.
Orriols, L., Wilchesky, M., Lagarde, E., & Suissa, S. (2013). Prescription of antidepressants and the risk of road traffic crash in the elderly: A case-crossover study. British Journal of Clinical Pharmacology, 76(5), 810815.
Ramaekers, J. G. (2003). Antidepressants and driver impairment: Empirical evidence from a standard on-the-road test. Journal of Clinical Psychiatry, 64(1), 2029.
Rapoport, M. J., & Banina, M. C. (2007). Impact of psychotropic medications on simulated driving: A critical review. CNS Drugs, 21(6), 503519.
Rapoport, M. J., Herrmann, N., Molnar, F., Rochon, P. A., Juurlink, D. N., Zagorski, B., et al. (2008). Psychotropic medications and motor vehicle collisions in patients with dementia. Journal of the American Geriatrics Society, 56(10), 19681970.
Rapoport, M. J., Zagorski, B., Seitz, D., Herrmann, N., Molnar, F., & Redelmeier, D. A. (2011). At-fault motor vehicle crash risk in elderly patients treated with antidepressants. American Journal of Geriatrics Psychiatry, 19(12), 9981006.
Ravera, S., Ramaekers, J. G., de Jong-van den Berg, L. T., & de Gier, J. J. (2012). Are selective serotonin reuptake inhibitors safe for drivers? What is the evidence? Clinical Therapeutics, 34(5), 10701083.
Ray, W. A., Fought, R. L., & Decker, M. D. (1992). Psychoactive drugs and the risk of injurious motor vehicle crashes in elderly drivers. American Journal of Epidemiology, 136(7), 878883.
Ray, W. A., Gurwitz, J., Decker, M. D., & Kennedy, D. L. (1992a). Medications and the safety of the older driver. Human Factors, 34(1), 3347.
Ray, W. A., Thapa, P. B., & Shorr, R. I. (1993). Medications and the older driver. Clinics in Geriatric Medicine, 9(2), 413438.
Redelmeier, D. A., & McLellan, B. A. (2013). Modern medicine is neglecting road traffic crashes. PLoS Medicine, 10(6), e1001463.
Sansone, R. A. & Sansone, L. A. (2009). Driving on antidepressants: Cruising for a crash? Psychiatry, 6, 1316.
Staplin, L., Gish, K., & Wagner, E. (2003). MaryPODS revisited: Updated crash analysis and implications for screening program implementation. Journal of Safety Research, 3(4), 389397.
van Laar, M. W., van Willgenburg, A. P., & Volkerts, E. R. (1995). Acute and subchronic effects of nefazodone and imipramine on highway driving, cognitive functions, and daytime sleepiness in healthy adult and elderly subjects. Journal of Clinical Psychopharmacology, 15(1), 3040.
Verster, J. C., & Ramaekers, J. G. (2009). Antidepressants and traffic safety. In Verster, J. C., Pandi-Perumal, S. R., Ramaekers, J. G., de Gier, J. J. (Eds.), Drugs, Driving and Traffic Safety. Basel-Boston-Berlin, Switzerland: Birkaeuser Verlag AG.
Wilde, G. J. (1982). The theory of risk homeostasis: Implications or safety and health. Risk analysis, 2(4), 209225.

Keywords

Antidepressants and Driving in Older Adults: A Systematic Review

  • Duncan H. Cameron (a1) and Mark J. Rapoport (a1)

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed