title: Risk of injurious road traffic crash after prescription of antidepressants.
abstract: OBJECTIVE
  To estimate the risk of road traffic crash associated with prescription of antidepressants.
  
  
  METHODS
  Data were extracted and matched from 3 French national databases: 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 nonresponsible drivers was conducted. Case-crossover analysis was performed to investigate the acute effect of medicine exposure.
  
  
  RESULTS
  72,685 drivers, identified by their national health care number, involved in an injurious crash in France from July 2005 to May 2008 were included. 2,936 drivers (4.0%) were exposed to at least 1 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 (odds ratio [OR] = 1.34; 95% CI, 1.22-1.47). The case-crossover analysis showed no association with treatment prescription, but the risk of road traffic crash increased after an initiation of antidepressant treatment (OR = 1.49; 95% CI, 1.24-1.79) and after a change in antidepressant treatment (OR = 1.32; 95% CI, 1.09-1.60).
  
  
  CONCLUSIONS
  Patients and prescribers should be warned about the risk of crash during periods of treatment with antidepressant medication and about particularly high vulnerability periods such as those when a treatment is initiated or modified.
authors.affiliation: Université Bordeaux Segalen, Equipe Injury Prevention and Control (PPCT), Institute of Public Health, Epidemiology, and Development (ISPED), Centre INSERM U897-Epidemiologie-Biostatistique, F-33000, Bordeaux, France. ludivine.orriols@isped.u-bordeaux2.fr
authors.forename: Ludivine
authors.initials: L
authors.lastname: Orriols
authors.forename: Raphaëlle
authors.initials: R
authors.lastname: Queinec
authors.forename: Pierre
authors.initials: P
authors.lastname: Philip
authors.forename: Blandine
authors.initials: B
authors.lastname: Gadegbeku
authors.forename: Bernard
authors.initials: B
authors.lastname: Delorme
authors.forename: Nicholas
authors.initials: N
authors.lastname: Moore
authors.forename: Samy
authors.initials: S
authors.lastname: Suissa
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Lagarde
mesh_terms: D000063:Accidents, Traffic / Q000706:statistics & numerical data*; D000328:Adult; D000368:Aged; D000928:Antidepressive Agents / Q000009:adverse effects* / Q000627:therapeutic use; D016022:Case-Control Studies; D018592:Cross-Over Studies; D003430:Cross-Sectional Studies; D003865:Major Depressive Disorder / Q000188:drug therapy* / Q000453:epidemiology*; D057915:Drug Substitution; D004359:Drug Therapy, Combination; D005260:Female; D005602:France; D006801:Humans; D008297:Male; D008875:Middle Aged; D012306:Risk; D013223:Statistics as Topic; D014947:Wounds and Injuries / Q000453:epidemiology*
chemical_list: D000928:Antidepressive Agents