Hostname: page-component-8448b6f56d-wq2xx Total loading time: 0 Render date: 2024-04-16T21:01:35.376Z Has data issue: false hasContentIssue false
  • English
  • Français

Driving performance in adults with ADHD: Results from a randomized, waiting list controlled trial with atomoxetine

Published online by Cambridge University Press:  15 April 2020

E. Sobanski ,
D. Sabljic ,
B. Alm ,
R.W. Dittmann ,
P.M. Wehmeier ,
G. Skopp  and
P. Strohbeck-Kühner
E. Sobanski*
Affiliation:
Central Institute of Mental Health, Department of Psychiatry and Psychotherapy, Medical Faculty Mannheim, University of Heidelberg, J 5, 68159Mannheim, Germany
D. Sabljic
Affiliation:
Central Institute of Mental Health, Department of Psychiatry and Psychotherapy, Medical Faculty Mannheim, University of Heidelberg, J 5, 68159Mannheim, Germany Ruprecht-Karls-University Heidelberg, Department of Legal and Traffic Medicine, Voßstr. 2, 69115Heidelberg, Germany
B. Alm
Affiliation:
Central Institute of Mental Health, Department of Psychiatry and Psychotherapy, Medical Faculty Mannheim, University of Heidelberg, J 5, 68159Mannheim, Germany
R.W. Dittmann
Affiliation:
Central Institute of Mental Health Mannheim, Eli Lilly Endowed Chair for Paediatric Psychopharmacology, Department of Child & Adolescent Psychiatry, Medical Faculty Mannheim, University of Heidelberg, J 5, 68159Mannheim, Germany
P.M. Wehmeier
Affiliation:
Central Institute of Mental Health, Department of Child and Adolescent Psychiatry, Medical Faculty Mannheim, University of Heidelberg, J 5, 68159Mannheim, Germany Vitos Hospital for Psychiatry and Psychotherapy, Weilstr. 10, 35789Weilmuenster, Germany
G. Skopp
Affiliation:
Ruprecht-Karls-University Heidelberg, Department of Legal and Traffic Medicine, Voßstr. 2, 69115Heidelberg, Germany
P. Strohbeck-Kühner
Affiliation:
Ruprecht-Karls-University Heidelberg, Department of Legal and Traffic Medicine, Voßstr. 2, 69115Heidelberg, Germany
*
*Corresponding author. Tel.: +49 621 17032852; fax: +49 621 17032855. E-mail address:esther.sobanski@zi-mannheim.de (E. Sobanski).
Get access

Abstract

Purpose:

To investigate effects of a 12-week treatment with atomoxetine (ATX) on driving performance in real traffic, driving-related neuropsychological performance tests and self-evaluation of driving in adult patients with ADHD compared to an untreated control group with ADHD.

Methods:

Parallel group design with an ATX and a waiting list group. At baseline and endpoint patients were evaluated with a standardized on-road driving test (SDBO), a driving-related neuropsychological test battery (Act and React Test System [ART2020]), and subjective measures of driving performance (one-week driving diary, Driver Coping Questionnaire).

Results:

Forty-three of the 64 included patients completed the study (n = 22 ATX, n = 21 controls). Mean intervention period was 11.9 ± 3.0 weeks, mean daily ATX dosage was 71.6 ± 14.9 mg. At endpoint, 60.1% of patients treated with ATX and 0% of waiting list group had reduced ADHD symptoms by greater or equal to 30%. In SDBO, ATX group reduced driving errors in three of four driving performance categories (attention, P < 0.05; risk-related self-control, P < 0.005; driver skills, P < 0.001), number of driving errors remained stable in control group. At endpoint, 47.6% of control group and 18.2% of ATX group (P < 0.05) did not fulfil the driving fitness criteria according to German Guidelines (percentile rank less or equal to 16 in one or more subtests in ART2020). Total number of self-reported critical traffic situations decreased from 12.0 to 6.8 per week in ATX group (P < 0.05) and remained stable in controls by 9.3 and 9.9 at baseline and endpoint (ns). Coping strategies with stressful traffic situations did not change within both groups.

Conclusion:

Our study provides first evidence that treatment with ATX improves driving performance in real traffic in adults with ADHD.

Keywords

AdultsADHDAtomoxetineDriving
Type
Original article
Information
European Psychiatry , Volume 28 , Issue 6 , August 2013 , pp. 379 - 385
Copyright
Copyright © European Psychiatric Association

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

American Psychiatric Association, Diagnostic and statistical manual of mental disorders. 4th edition revisedWashington, DC: American Psychiatric Press; 2000.Google Scholar
Barkley, RAMurphy, KRAttention deficit hyperactivity disorder: a clinical workbook. 3rd editionNew York: Guilford Press; 2005.Google Scholar
Barkley, RAGuevremont, DCAnastopoulos, ADDuPaul, GJShelton, TLDriving-related risks and outcomes of attention deficit hyperactivity disorder in adolescents and young adults: a 3-to 5-year follow-up survey. Pediatrics 1993;92:212–218.Google Scholar
Barkley, RAMurphy, KRKwasnik, DMotor vehicle driving competencies and risks in teens and young adults with attention deficit hyperactive disorder. Pediatrics 1998;98:1089–1095.Google Scholar
Barkley, RAMurphy, KRDuPaul, GIBush, TDriving in young adults with attention deficit hyperactive disorder: knowledge, performance, adverse outcomes, and the role of executive functioning. J Int Neuropsychol Soc 2002;8:655–672.CrossRefGoogle Scholar
Barkley, RAAnderson, DLKruesi, MA pilot study of atomoxetine on driving performance in adults with ADHD. J Atten Disord 2007;10:306–313.CrossRefGoogle ScholarPubMed
Begutachtungs-Leitlinien zur Kraftfahrereignung, Bundesanstalt für Straßenwesen (Bast) Mensch und Sicherheit, M 115. Bremerhafen, Germany: Verlag für neue Wissenschaft GmbH; 2010.Google Scholar
Bukasa, BART2020 – Das neue Multimedia-Testgerät für die FahreignungsbegutachtungMeyer-Gramcko, FVerkehrspsychologie auf neuen Wegen: Herausforderungen von Strasse, Wasser, Luft und Schiene (I). Bonn, Germany: Deutscher Psychologen Verlag; 1999. p. 381–401.Google Scholar
Bukasa, BChrist, RPonocny-Seliger, ESmuc, MWenniger, UValiditätsüberprüfung verkehrspsychologischer Leistungstests für die Fahreignungsbegutachtung. Zeitschrift für Verkehrssicherheit 2003;49:191–197.Google Scholar
Chamberlain, SRSahakian, BJThe neuropsychiatry of impulsivity. Curr Opin Psychiatry 2007;20:255–261.CrossRefGoogle ScholarPubMed
Chamberlain, SRDel Campo, NDowson, JMuller, UClark, LRobbins, TW, et al.Atomoxetine improved response inhibition in adults with attention deficit/hyperactivity disorder. Biol Psychiatry 2007;62:977–984.CrossRefGoogle ScholarPubMed
Christiansen, HKis, BHirsch, OMatthies, SHebebrand, JUekermann, J, et al.A German validation of the Conners Adult ADHD Rating Scales (CAARS) II: Reliability, validity, diagnostic sensitivity and specificity. Eur Psychiatry 2012;27:321–328.CrossRefGoogle Scholar
Conners, CKErhardt, DSparrow, EConners Adult ADHD Rating Scales (CAARS). North Tonawanda: Multi Health Systems Inc.; 1999.Google Scholar
Cox, DJMerkel, RLKovatchev, BSeward, REffects of stimulant medication on driving performance of young adults with attention deficit/hyperactivity disorder: a preliminary double-blind placebo-controlled trial. J Nerv Ment Dis 2000;188:230–234.CrossRefGoogle ScholarPubMed
Cox, DJHumphrey, JWMerkel, RLPenbertyh, JKKovatchev, BControlled-release methylphenidate improves attention during on-road driving by adolescents with attention deficit/hyperactivity disorder. J Am Board Fam Pract 2004;17:235–239.CrossRefGoogle ScholarPubMed
Cox, DJMerkel, RLMoore, MThorndike, FMuller, CKovatchev, BRelative benefits of stimulant therapy with OROS methylphenidate versus mixed amphetamine salts extended release in improving the driving performance of adolescent drivers with attention deficit/hyperactivity disorder. Pediatrics 2006;118:704–710.CrossRefGoogle ScholarPubMed
Cox, DJDavis, MMikami, AYSing, HMerkel, RLBurket, RLong-acting methylphenidate reduces collision rate of young adult drivers with attention deficit-/hyperactivity disorder. J Clin Psychoharmacol 2012;32:225–230.CrossRefGoogle ScholarPubMed
De Zwaan, MGruss, BMuller, AGraap, HMartin, AGlaesmer, H, et al.The estimated prevalence and correlates of adult ADHD in a German community sample. Eur Arch Psychiatry Clin Neurosci 2012;262:79–86.CrossRefGoogle Scholar
Emol, AKMatthews, GFunke, GWarm JS, Stress vulnerability, coping and risk-taking behaviors during simulated driving. Proceedings of the Human Factors and Ergonomics Society 40th Annual Meeting 2004;48:1228–1232.Google Scholar
Fayyad, JDe Graaf, RKessler, R, et al.Cross-national prevalence and correlates of adult attention deficit/hyperactivity disorder. Br J Psychiatry 2007;190:402–409.CrossRefGoogle Scholar
Fischer, MBarkley, RASmallish, LFletcher, KHyperactive children as young adults: driving abilities, safe driving behaviour, and adverse driving outcomes. Acc Anal Prev 2006;39:94–105.CrossRefGoogle ScholarPubMed
Jerome, LSegal, AHabinski, LWhat we know about ADHD and driving risk: a literature review, meta-analysis and critique. J Can Acad Child Adolesc Psychiatry 2006;15:105–125.Google ScholarPubMed
Kay, GGMichaels, APakull, BSimulated driving changes in young adults with ADHD receiving mixed amphetamine salts extended release and atomoxetine. J Atten Disord 2009;12:316–329.CrossRefGoogle ScholarPubMed
Lehrl, SMehrfachwahl-Wortschatz-Intelligenztest: Form B. Erlangen, Germany: Straube; 1997.Google Scholar
Matthews, GDesmond, PAJoyner, LCarcary, BGilliland, KValidation of the driver stress inventory and driver coping questionnaire. Valencia, Spain: International Conference on Traffic and Transport Psychology; 1996.Google Scholar
Medori, RRamos-Quiroga, JACasas, M, et al.A randomized, placebo-controlled trial of three fixed dosages of prolonged-release OROS methylphenidate in adults with attention deficit/hyperactivity disorder. Biol Psychiatry 2008;63:981–989.CrossRefGoogle ScholarPubMed
Nada-Raja, SLangley, JDMcGee, RWilliams, SMBuff, DJReeder, AIInattentive and hyperactive behaviors and driving offenses in adolescence. J Am Acad Child Adolesc Psychiatry 1997;36:515–522.CrossRefGoogle ScholarPubMed
Retz-Junginger, PRetz, WBlocher, DStieglitz, RDGeorg, TSupprian, T, et al.Validity and reliability of the German short version of the Wender-Utah rating scale for the retrospective assessment of attention deficit/hyperactivity disorder. Nervenarzt 2003;74:987–993.CrossRefGoogle ScholarPubMed
Roesler, MRetz, WRetz-Junginger, P, et al.Instrumente zur Diagnostik der Aufmerksamkeitsdefizit-/Hyperaktivitätsstörung (ADHS) im Erwachsenenalter Selbstbeurteilungsskala (ADHS-SB) und Diagnosecheckliste (ADHS-DC). Nervenarzt 2004;75:888–895.Google Scholar
Schubert, WWagner, TDie psychologische Fahrverhaltensbeobachtung – Grundlagen, Methodik und Anwendungsmöglichkeiten. Zeitschrift für Verkehrssicherheit 2003;49:119–127.Google Scholar
Sobanski, ESabljic, DAlm, BSkopp, GKettler, NMattern, R, et al.Driving-related risks and impact of methylphenidate treatment on driving in adults with ADHD. J Neural Transm 2008;115:347–356.CrossRefGoogle Scholar
Sobanski, ESabljic, DAlm, BBaehr, CDittmann, RWSkopp, G, et al.A randomized, waiting list controlled 12-week trial of atomoxetine in adults with ADHD. Pharmacopsychiatry 2012;45:100–107.Google ScholarPubMed
Strohbeck-Kuehner, PMattern, RKief, SBewältigungsstrategien und Fahrverhalten. Kongressbericht 2007 der Deutschen Gesellschaft für Verkehrsmedizin e.V., Berichte der Bundesanstalt für Straßenwesen – Mensch und Sicherheit 2008;195:58–61.Google Scholar
Verster, JCBekker, EMde Roos, MMinova, AEijken, EJKooij, JJ, et al.Methylphenidate significantly improves driving performance of adults with attention deficit hyperactivity disorder: a randomized crossover trial. J Psychopharmacol 2008;22:230–237.CrossRefGoogle ScholarPubMed
Volkerts, ERvan Laar, MWvanWilligenburg, APPPlomp, TAMaes, RAAA comparative study of on-the-road and stimulated driving performance after nocturnal treatment with lormetazepam 1 mg and oxazepam 50 mg. Hum Psychopharmacol 1992;7:297–309.CrossRefGoogle Scholar
Wittchen, HUWunderlich, UGruschwitz, SZaudig, MStrukturiertes klinisches Interview für DSM-V. SKID-I. Göttingen, Germany: Hogrefe; 1997.Google Scholar
Woods, SWLovejoy, DWBall, JDNeuropsychological characteristics of adults with ADHD: a comprehensive review of initial studies. Clin Neuropsychol 2002;16:12–34.CrossRefGoogle ScholarPubMed
Woodward, LJFergusson, DMHorwood, LJDriving outcomes of young people with attention difficulties in adolescence. J Am Acad Child Adolesc Psychiatry 2000;39:627–634.CrossRefGoogle ScholarPubMed
Submit a response

Comments

No Comments have been published for this article.