Antidepressants and driving ability: results from a clinical study

Area of Science:

• Neuroscience
• Psychiatry
• Clinical Psychology

Background:

• Depression frequently causes psychomotor disturbances impacting driving ability.
• Sedative effects of some antidepressants can further impair driving performance.
• Assessing driving fitness in depressed patients is crucial for public safety.

Purpose of the Study:

• To evaluate the impact of antidepressant monotherapy on psychomotor functions essential for driving.
• To assess driving-related skills in patients with major depressive disorder in a clinical setting.

Main Methods:

• 100 inpatients meeting ICD-10/DSM-IV criteria for major depressive disorder were tested.
• Psychomotor functions (visual perception, reaction time, attention, vigilance, stress tolerance) were measured using the ART-90 and Wiener Testsystem.
• Symptom severity was assessed using the Hamilton Rating Scale for Depression.

Main Results:

• 24% of patients showed no clinically relevant psychomotor disturbances; 60% had mild-to-moderate impairments; 16% were severely impaired.
• Patients on selective serotonin reuptake inhibitors (SSRIs) or mirtazapine demonstrated better performance than those on tricyclic antidepressants (TCAs).
• Differences were most significant in reactivity, stress tolerance, and selective attention; no significant difference was found between TCAs and venlafaxine.

Conclusions:

• Approximately 16% of discharged depressed patients are unfit to drive, with 60% performing at a questionable level.
• Individual counseling regarding driving fitness is recommended, considering potential compensatory factors.
• SSRIs and mirtazapine appear advantageous over TCAs and venlafaxine for maintaining driving-related psychomotor functions, though causality is not established.