Actual driving performance and psychomotor function in healthy subjects after acute and subchronic treatment with escitalopram, mirtazapine, and placebo: a crossover trial.
OBJECTIVE
The effects of escitalopram 10 to 20 mg/day and mirtazapine 30 to 45 mg/day on actual driving and psychomotor performance of 18 healthy subjects were determined in a randomized, double-blind, placebo-controlled, multiple-dose, 3-way crossover trial.


METHODS
Each treatment period lasted for 15 days and was separated from the next period by a washout period of at least 13 days. Subjects received an evening dose of escitalopram 10 mg, mirtazapine 30 mg, or placebo from days 1 to 7 and an evening dose of escitalopram 20 mg, mirtazapine 45 mg, or placebo from days 8 to 15. On days 2, 9, and 16, reflecting acute period, dose increase, and steady state, respectively, the Road Tracking Test was performed. The main parameter was standard deviation of lateral position. Psychomotor performance was also assessed on days 2, 9, and 16 by laboratory computer tasks. Subjective sleep quality was measured with the Groninger Sleep Quality Scale, and mood was measured by visual analogue scales.


RESULTS
Treatment differences were apparent during the acute treatment period, in which subjects treated with mirtazapine 30 mg performed less well on the driving test as compared to placebo. The Divided Attention Task results also revealed a significant increase in tracking error after a single dose of mirtazapine 30 mg as compared to placebo. Mirtazapine decreased feelings of alertness and contentedness. Mirtazapine did not affect performance on days 9 and 16 of treatment. Escitalopram did not affect driving, psychomotor performance, or subjective mood throughout treatment.


CONCLUSIONS
Driving performance, as well as psychomotor functioning, was not affected by escitalopram treatment in healthy subjects. Driving performance was significantly impaired after ingestion of mirtazapine 30 mg during the acute treatment period.
Wingen
Marleen
M
Experimental Psychopharmacology Unit, Brain and Behaviour Institute, University of Maastricht, Maastricht, the Netherlands. m.wingen@psychology.unimaas.nl
Bothmer
John
J
Langer
Stefan
S
Ramaekers
Johannes G
JG
D000328:Adult; D000339:Affect / Q000187:drug effects; D000929:Antidepressive Agents, Tricyclic / Q000009:adverse effects / Q000494:pharmacology*; D001334:Automobile Driving / Q000523:psychology*; D002940:Circadian Rhythm; D015283:Citalopram / Q000009:adverse effects / Q000494:pharmacology*; D003198:Computer Simulation; D018592:Cross-Over Studies; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D005221:Fatigue / Q000139:chemically induced; D005260:Female; D006801:Humans; D008297:Male; D008803:Mianserin / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000494:pharmacology*; D000078785:Mirtazapine; D009483:Neuropsychological Tests / Q000706:statistics & numerical data; D010919:Placebos; D011597:Psychomotor Performance / Q000187:drug effects*; D017367:Selective Serotonin Reuptake Inhibitors / Q000009:adverse effects / Q000494:pharmacology*; D007319:Sleep Initiation and Maintenance Disorders / Q000139:chemically induced
D000929:Antidepressive Agents, Tricyclic; D015283:Citalopram; D008803:Mianserin; D000078785:Mirtazapine; D010919:Placebos; D017367:Selective Serotonin Reuptake Inhibitors