Medications and impaired driving.
OBJECTIVE
To describe the association of specific medication classes with driving outcomes and provide clinical recommendations.


METHODS
The MEDLINE and EMBASE databases were searched for articles published from January 1973 to June 2013 on classes of medications associated with driving impairment. The search included outcome terms such as automobile driving, motor vehicle crash, driving simulator, and road tests.


METHODS
Only English-language articles that contained findings from observational or interventional designs with ≥ 10 participants were included in this review. Cross-sectional studies, case series, and case reports were excluded.


RESULTS
Driving is an important task and activity for the majority of adults. Some commonly prescribed medications have been associated with driving impairment measured by road performance, driving simulation, and/or motor vehicle crashes. This review of 30 studies identified findings with barbiturates, benzodiazepines, hypnotics, antidepressants, opioid and nonsteroidal analgesics, anticonvulsants, antipsychotics, antiparkinsonian agents, skeletal muscle relaxants, antihistamines, anticholinergic medications, and hypoglycemic agents. Additional studies of medication impact on sedation, sleep latency, and psychomotor function, as well as the role of alcohol, are also discussed.


CONCLUSIONS
Psychotropic agents and those with central nervous system side effects were associated with measures of impaired driving performance. It is difficult to determine if such associations are actually a result of medication use or the medical diagnosis itself. Regardless, clinicians should be aware of the increased risk of impaired driving with specific classes of medications, educate their patients, and/or consider safer alternatives.
St Louis College of Pharmacy, St Louis, MO, USA.
Amanda
A
Hetland
David B
DB
Carr
D001334:Automobile Driving; D064420:Drug-Related Side Effects and Adverse Reactions; D006801:Humans
automobile driving; driving safety; drugs and driving; medication safety; potentially driver-impairing medications