Driving on antidepressants: cruising for a crash?

Antidepressants are commonly prescribed medications that carry an imprecise risk of driving impairment. In this edition of The Interface, we explore the relationship between antidepressant medications and driving impairment. We conclude that while there may be a small risk of driving impairment with these medications, this risk is considerably heightened under particular clinical conditions. These conditions include the advanced age of the driver, initial dosing and start-up of the antidepressant, rapid escalation of antidepressant doses, high-dose antidepressants, presence of active and severe depressive symptoms (i.e., the antidepressant is merely functioning as a pharmacological marker for severe depressive illness), and/or coadministration of other psychotropic medications, especially benzodiazepines. Clinicians need to be mindful of these specific clinical conditions when prescribing antidepressants to patients.