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Risk of injurious road traffic crash after prescription of antidepressants
  1. E Lagarde1,2,
  2. R Queinec3,
  3. P Philip4,
  4. B Gadegbeku5,6,7,
  5. B Delorme8,
  6. N Moore9,
  7. S Suissa10,
  8. L -R Salmi1,2,11,
  9. L Orriols1,2,
  10. on behalf of the CESIR research group
  1. 1University of Bordeaux, ISPED, INSERM U897 Research Centre ‘Epidemiology and Biostatistics’, Bordeaux, France
  2. 2INSERM, ISPED, Injury Prevention and Control Research Team, INSERM U897, Bordeaux, France
  3. 3Pôle Entre-Deux-Mers, CH, Cadillac, France
  4. 4USR CNRS SANPSY 3413, University of Bordeaux, Bordeaux, France
  5. 5University of Lyon, Lyon, France
  6. 6IFSTTAR, UMR T 9405, UMRESTTE, Bron, France
  7. 7University of Lyon 1, UMRESTTE, Lyon, France
  8. 8Service de l'Évaluation de la Surveillance du Risque et de l'Information sur le Médicament, AFSSAPS, Saint-Denis, France
  9. 9INSERM U657, CICP0005, Pharmacology, University of Bordeaux, Bordeaux, France
  10. 10Department of Epidemiology and Biostatistics, Centre for Clinical Epidemiology, McGill University, Montreal, Quebec, Canada
  11. 11University Hospital Pellegrin, Bordeaux, France

    Abstract

    Background Antidepressants are commonly used worldwide. Experimental studies have suggested that antidepressants may impair driving abilities.

    Aims/Objectives/Purpose The study aims to estimate the risk of road traffic crash associated with prescription of antidepressants.

    Methods Data from three French national databases were extracted and matched: the national health care insurance database, police reports, and the national police database of injurious crashes. A case-control analysis comparing 34 896 responsible versus 37 789 non-responsible drivers was conducted. Case-crossover analysis was performed to investigate the acute effect of medicine exposure.

    Results/Outcomes 72 685 drivers identified by their national healthcare number, involved in an injurious crash in France over the July 2005 to May 2008 period, were included. 2936 drivers (4.0%) were exposed to at least one antidepressant on the day of the crash. The results showed a significant association between the risk of being responsible for a crash and prescription of antidepressants (OR=1.34 (1.22 to 1.47)). The case-crossover analysis showed no association with treatment prescription but the risk of road traffic crash increased after an initiation of an antidepressant treatment (OR=1.49 (1.24 to 1.79)) and after a change in antidepressant treatment (OR=1.32 (1.09 to 1.60)).

    Significance/Contribution to the Field Patients and prescribers should be warned about the risk of crash during periods of antidepressant medication and particularly high vulnerability periods such as those when a treatment is initiated or modified.

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