Nick N J J M van der Sluiszen1, Annemiek Vermeeren1, Joke H van Dijken2, Aurora J A E van de Loo3,4, Janet L Veldstra2, Dick de Waard2, Joris C Verster3,4,5, Karel A Brookhuis2, Johannes G Ramaekers1. 1. Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands. 2. Department of Clinical and Developmental Neuropsychology, University of Groningen, Groningen, The Netherlands. 3. Division Pharmacology, Utrecht University, Utrecht, The Netherlands. 4. Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands. 5. Centre for Human Psychopharmacology, Swinburne University, Melbourne, Australia.
Abstract
OBJECTIVE: To assess driving performance and neurocognitive skills of long-term users of sedating antidepressants, in comparison to healthy controls. METHODS: Thirty-eight long-term (>6 months) users of amitriptyline (n = 13) and mirtazapine (n = 25) were compared to 65 healthy controls. Driving performance was assessed using a 1-h standardised highway driving test in actual traffic, with road-tracking error (standard deviation of lateral position [SDLP]) being the primary measure. Secondary measures included neurocognitive tasks related to driving. Performance differences between groups were compared to those of blood alcohol concentrations of 0.5 mg/ml to determine clinical relevance. RESULTS: Compared to controls, mean increase in SDLP of all antidepressant users was not significant, nor clinically relevant (+0.75 cm, 95% CI: -0.83 cm; +2.33 cm). However, users treated less than 3 years (n = 20) did show a significant and clinically relevant increase in SDLP (+2.05 cm). No significant effects were observed on neurocognitive tasks for any user group, although large individual differences were present. Most results from neurocognitive tests were inconclusive, while a few parameters confirmed non-inferiority for users treated longer than 3 years. CONCLUSION: The impairing effects of antidepressant treatment on driving performance and neurocognition mitigate over time following long-term use of 3 years.
OBJECTIVE: To assess driving performance and neurocognitive skills of long-term users of sedating antidepressants, in comparison to healthy controls. METHODS: Thirty-eight long-term (>6 months) users of amitriptyline (n = 13) and mirtazapine (n = 25) were compared to 65 healthy controls. Driving performance was assessed using a 1-h standardised highway driving test in actual traffic, with road-tracking error (standard deviation of lateral position [SDLP]) being the primary measure. Secondary measures included neurocognitive tasks related to driving. Performance differences between groups were compared to those of blood alcohol concentrations of 0.5 mg/ml to determine clinical relevance. RESULTS: Compared to controls, mean increase in SDLP of all antidepressant users was not significant, nor clinically relevant (+0.75 cm, 95% CI: -0.83 cm; +2.33 cm). However, users treated less than 3 years (n = 20) did show a significant and clinically relevant increase in SDLP (+2.05 cm). No significant effects were observed on neurocognitive tasks for any user group, although large individual differences were present. Most results from neurocognitive tests were inconclusive, while a few parameters confirmed non-inferiority for users treated longer than 3 years. CONCLUSION: The impairing effects of antidepressant treatment on driving performance and neurocognition mitigate over time following long-term use of 3 years.
Authors: Mark J Rapoport; Brandon Zagorski; Dallas Seitz; Nathan Herrmann; Frank Molnar; Donald A Redelmeier Journal: Am J Geriatr Psychiatry Date: 2011-12 Impact factor: 4.105
Authors: Nick N J J M van der Sluiszen; Annemiek Vermeeren; Joris C Verster; Aurora J A E van de Loo; Joke H van Dijken; Janet L Veldstra; Karel A Brookhuis; Dick de Waard; Johannes G Ramaekers Journal: Hum Psychopharmacol Date: 2019-11 Impact factor: 1.672