Abstract
Background
Depression is a common mental disorder with cognitive deficits, but little information is available on the effects of antidepressant treatment on driving performance in depressed patients.
Aims
Assessing actual driving performance and cognition of depressed patients receiving long-term antidepressant treatment.
Materials and methods
Performance was assessed in depressed patients receiving selective serotonin reuptake inhibitor (SSRI) or serotonin and noradrenalin reuptake inhibitor (SNRI) treatment for 6–52 weeks and in matched healthy controls by means of two standardised on-the-road driving tests and laboratory tests of cognition.
Results
Data showed poorer driving performance as indicated by a higher standard deviation of lateral position or ‘weaving motion’ in medicated patients relative to controls. Time to speed adaptation and critical flicker fusion threshold were also impaired in medicated patients. The Hamilton Depression Rating Scale scores in medicated patients were significantly higher as compared to that of controls. No other significant results between the two groups were demonstrated on the variables of the driving tests and laboratory tests of cognition.
Conclusions
The depressed patients receiving long-term treatment with SSRI- and SNRI-type antidepressants show impaired driving performance. This impairment in driving performance can probably be attributed to residual depressive symptoms instead of the antidepressant treatment.
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References
Amado-Boccara I, Gougoulis N, Poirier Littre MF, Galinowski A, Loo H (1995) Effects of antidepressants on cognitive functions: a review. Neurosci Biobehav Rev 19:479–493
Austin MP, Mitchell P, Goodwin GM (2001) Cognitive deficits in depression: possible implications for functional neuropathology. Br J Psychiatry 178:200–206
Barbone F, McMahon AD, Davey PG, Morris AD, Reid IC, McDevitt DG, MacDonald TM (1998) Association of road-traffic accidents with benzodiazepine use. Lancet 352:1331–1336
Beck AT, Ward CH, Mendelson M, Mock J, Erbaugh J (1961) An inventory for measuring depression. Arch Gen Psychiatry 4:561–571
Brookhuis KA, de Waard D, Mulder B (1994) Measuring driving performance by car-following in traffic. Ergonomics 37:427–434
Brunnauer A, Laux G (2003) Fahrtuchtigkeit und Antidepressiva. Psychiatr Prax 30(Suppl 2):S102–S105
Burt DB, Zembar MJ, Niederehe G (1995) Depression and memory impairment: a meta-analysis of the association, its pattern, and specificity. Psychol Bull 117:285–305
Conners CX (1992) Conners’ continuous performnace test computer program user’s guide. Multi-Health Systems, Toronto, Canada
Curran S (1990) Critical flicker fusion techniques in psychopharmacology. In: Hindmarch I, Stonier PD (eds) Human psychopharmacology. Wiley, Chichester
Curran S, Wattis JP (1998) Critical flicker fusion threshold: a useful research tool in patients with Alzheimers disease. Hum Psychopharmacol 13:337–355
Dornhoefer SM, Unema PJ, Velichkovsky BM (2002) Blinks, blanks and saccades: how blind we really are for relevant visual events. Prog Brain Res 140:119–131
Gerhard U, Hobi V (1984) Cognitive-psychomotor functions with regard to fitness for driving of psychiatric patients treated with neuroleptics and antidepressants. Neuropsychobiology 12:39–47
Grabe HJ, Wolf T, Gratz S, Laux G (1998) The influence of polypharmacological antidepressive treatment on central nervous information processing of depressed patients: implications for fitness to drive. Neuropsychobiology 37:200–204
Hamilton M (1967) Development of a rating scale for primary depressive illness. Br J Soc Clin Psychol 6:278–296
Leveille SG, Buchner DM, Koepsell TD, McCloskey LW, Wolf ME, Wagner EH (1994) Psychoactive medications and injurious motor vehicle collisions involving older drivers. Epidemiology 5:591–598
Louwerens JW, Gloerich ABM, De Vries G, Brookhuis KA, O’Hanlon JF (1987) The relationship between drivers’ blood alcohol concentration (BAC) and actual driving performance during high speed travel. In: Noordzij PC, Roszbach R (eds) Alcohol, drugs and traffic safety. Elsevier, Amsterdam, pp 183–186
McNair DM, Lorr M, Droppleman LF (1992) Manual for the profile of mood states (revised). Educational and Industrial Testing Service, San Diego CA
Mulder-Hajonides van der Meulen WREH (1981) Measurement of subjective sleep quality. Proceedings of the international European sleep conference. Elsevier, Amsterdam, The Netherlands
O’Hanlon JF (1984) Driving performance under the influence of drugs: rationale for, and application of, a new test. Br J Pharmacol 18(Suppl 1):121S–129S
O’Hanlon J, Robbe HWJ, Vermeeren A, VanLeeuwen C, Danjou PE (1998) Venlafaxine’s effects on healthy volunteers’ driving, psychomotor, and vigilance performance during 15-day fixed and incremental dosing regimens. J Clin Psychopharmacol 18:212–221
Ramaekers JG (2003) Antidepressants and driver impairment: empirical evidence from a standard on-the-road test. J Clin Psychiatry 64:20–29
Ramaekers JG, Ansseau M, Muntjewerff ND, Sweens JP, O’Hanlon JF (1997) Considering the P450 cytochrome system as determining combined effects of antidepressants and benzodiazepines on actual driving performance of depressed outpatients. Int Clin Psychopharmacol 12:159–169
Ramaekers G, Lamers J, Verhey F, Muntjewerff D, Mobbs E, Sanders N, Lewis M, Lockton A (2002) A comparative study of the effects of carbamazepine and the NMDA receptor antagonist remacemide on road tracking and car-following performance in actual traffic. Psychopharmacology (Berl) 159:203–210
Ray WA, Fought RL, Decker MD (1992) Psychoactive drugs and the risk of injurious motor vehicle crashes in elderly drivers. Am J Epidemiol 136:873–883
Rey A (1964) L’examen psychologique dans les cas d’encéphalopathie traumatique. Presses Universitaires de France, Paris, France
Riedel WJ, Eikmans K, Heldens A, Schmitt JA (2005) Specific serotonergic reuptake inhibition impairs vigilance performance acutely and after subchronic treatment. J Psychopharmacol 19:12–20
Schmitt JA, Ramaekers JG, Kruizinga MJ, van Boxtel MP, Vuurman EF, Riedel WJ (2002a) Additional dopamine reuptake inhibition attenuates vigilance impairment induced by serotonin reuptake inhibition in man. J Psychopharmacol 16:207–214
Schmitt JA, Riedel WJ, Vuurman EF, Kruizinga M, Ramaekers JG (2002b) Modulation of the critical flicker fusion effects of serotonin reuptake inhibitors by concomitant pupillary changes. Psychopharmacology (Berl) 160:381–386
Stroop JR (1935) Studies of interference in serial verbal reactions. J Exp Psychol 18:643–662
Vaa T (2003) Impairments, diseases, age and their relative risks of accident involvement: results from a meta-analysis. IMMORTAL-deliverable 1.1 Project funded by the European Commission under the transport RTD Programme of the 5th framework programme
Wechsler D (1981) The measurement and appraisal of adult intelligence. Williams and Wilkins, Baltimore
Zakzanis KK, Leach L, Kaplan E (1998) On the nature and pattern of neurocognitive function in major depressive disorder. Neuropsychiatry Neuropsychol Behav Neurol 11:111–119
Acknowledgements
The authors are thankful to Dr. Debije, Dr. Geeraerts, Dr. Meijer, Dr. Havermans, Dr. Peeters and Dr. Van Boxtel for recruiting and selecting the patients and to Marije Meeuwissen, Nadine Kessen, Michiel Schraven, Irma Brauers and Henk Brauers for their work during data collection. This study was conducted as a part of the IMMORTAL project which was funded by the EU 5th Framework Programme (http://www.immortal.or.at). Additional financial support was received from the Hersenstichting Nederland.
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Wingen, M., Ramaekers, J.G. & Schmitt, J.A.J. Driving impairment in depressed patients receiving long-term antidepressant treatment. Psychopharmacology 188, 84–91 (2006). https://doi.org/10.1007/s00213-006-0471-7
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DOI: https://doi.org/10.1007/s00213-006-0471-7