Prescription pattern of driving-impairing psychotropic medications in Tabriz in 2022

Some psychotropic medications could impair drivers' cognitive skills, concentration and reaction by affecting the central nervous system (CNS), thereby increasing the risk of traffic accidents. However, there is limited evidence regarding the prescription pattern of these medications in Iran. The present study aims to investigate the prescription pattern of psychotropic medications impairing driving in Tabriz, Iran.

In this descriptive-analytical cross-sectional study, psychotropic medications prescribed by physicians in Tabriz from March, 2021, to March, 2022, were reviewed. The data were obtained from Iranian Social Security Organization (SSO), which included 1,167,460 eligible prescriptions. Psychotropic medications were classified into six main categories based on reliable scientific sources, and their level of effect on driving was determined using driving-impairing medication classification system. The data were analyzed using Stata 17.0 and Chi-square test. The significance level was considered to be less than 0.05.

The results showed out of 1,167,460 prescribed psychotropic medications, 65.32% were for women, and the rest were for men. The most frequently prescribed medications were antidepressants (38.07%), followed by anxiolytics (18.60%) and antipsychotics (15.48%), respectively. More than half of the medications (57.10%) was categorized to have moderate effect, 23.73% was categorized to have mild effect and 18.87% was categorized to have severe effect on driving. Gabapentin, sertraline, nortriptyline, fluoxetine and trifluoperazine were the most frequently prescribed medications, respectively. A significant correlation was observed between the impairment category of prescribed medications and patients' gender and age (P <0.001). Additionally, general practitioners prescribed the highest number of medications with severe adverse effects, while neurosurgeons, general surgeons, neurologists and psychiatrists prescribed the highest number of medications with moderate adverse effects on driving.

More than half of the prescribed psychotropic medications in Tabriz was categorized to have moderate effects on driving, and about one-fifth was categorized to have severe effects. Antidepressants, anxiolytics and antipsychotics are considered to have the most relevant impairing effects on driving according to the categorization system, with gabapentin, sertraline, nortriptyline, fluoxetine and trifluoperazine being the most frequently prescribed medications. The findings highlighted the importance of raising awareness among physicians and patients about the effects of psychotropic medications on driving.