title: Prescription of antidepressants and the risk of road traffic crash in the elderly: a case-crossover study.
abstract: OBJECTIVE
  To investigate the impact of antidepressants on the risk of road traffic crash in the elderly.
  
  
  METHODS
  Reports from the Universal Quebec Automobile Insurance Agency database were matched with data on antidepressant prescription from the Quebec Health Insurance Agency. The case-crossover analysis consisted in comparing exposure during a period immediately before the crash with exposure during earlier periods, for the same subject.
  
  
  RESULTS
  One hundred and nine thousand four hundred and six drivers between 66 and 84 years of age involved in a traffic crash between 1988 and 2000 were included. Two thousand nine hundred and nineteen (2.7%) were exposed to an antidepressant on the day of the crash. Case-crossover analysis found an increased risk of crash in drivers with a prescription of antidepressants before their crash when compared with a prescription of antidepressants 4 to 8 months before the crash (OR = 1.19, 95% CI 1.08, 1.30 to 1.42. 95% CI 1.30, 1.55). With the most recent control periods, results were not significant.
  
  
  CONCLUSIONS
  A patient's mental state is probably more similar between two periods that are close to each other than up to 8 months before. Consequently, the risk of crash is likely to be linked to symptoms of depression.
authors.affiliation: University Bordeaux, ISPED, Bordeaux, France; INSERM, Equipe PPCT, ISPED, Centre INSERM U897-Epidemiologie-Biostatistique, Bordeaux, France.
authors.forename: Ludivine
authors.initials: L
authors.lastname: Orriols
authors.forename: Machelle
authors.initials: M
authors.lastname: Wilchesky
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Lagarde
authors.forename: Samy
authors.initials: S
authors.lastname: Suissa
mesh_terms: D000063:Accidents, Traffic / Q000706:statistics & numerical data*; D000368:Aged; D000369:Aged, 80 and over; D000928:Antidepressive Agents / Q000009:adverse effects* / Q000627:therapeutic use; D018592:Cross-Over Studies; D016208:Databases, Factual; D003863:Depression / Q000188:drug therapy*; D006801:Humans; D011792:Quebec; D012306:Risk; D013997:Time Factors
chemical_list: D000928:Antidepressive Agents
keywords: antidepressants; case-crossover; elderly; epidemiology; traffic crashes