Psychotropic drugs and risk of motor vehicle accidents: a population‐based case‐control study

Aim To examine comprehensively the relationship between exposure to four classes of psychotropic drugs including antipsychotics, antidepressants, benzodiazepines (BZDs) and Z‐drugs, and motor vehicle accidents (MVAs). Method The authors conducted a matched case‐control study of 5183 subjects with MV...

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Published inBritish journal of clinical pharmacology Vol. 75; no. 4; pp. 1125 - 1133
Main Authors Chang, Chia‐Ming, Wu, Erin Chia‐Hsuan, Chen, Chuan‐Yu, Wu, Kuan‐Yi, Liang, Hsin‐Yi, Chau, Yeuk‐Lun, Wu, Chi‐Shin, Lin, Keh‐Ming, Tsai, Hui‐Ju
Format Journal Article
LanguageEnglish
Published England Blackwell Science Inc 01.04.2013
Subjects
Accidents, Traffic
Adolescent
Adult
Aged
antidepressants
Antidepressive Agents - adverse effects
Antipsychotic Agents - adverse effects
antipsychotics
benzodiazepines
Benzodiazepines - adverse effects
Case-Control Studies
Databases, Factual
Dose-Response Relationship, Drug
Female
Humans
Hypnotics and Sedatives - adverse effects
Male
Middle Aged
motor vehicle accidents
Pharmacoepidemiology
psychotropic drugs
Taiwan
Z‐drugs
Taiwan
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Abstract Aim To examine comprehensively the relationship between exposure to four classes of psychotropic drugs including antipsychotics, antidepressants, benzodiazepines (BZDs) and Z‐drugs, and motor vehicle accidents (MVAs). Method The authors conducted a matched case‐control study of 5183 subjects with MVAs and 31 093 matched controls, identified from the claims records of outpatient service visits during the period from 2000 to 2009. Inclusion criteria were defined as subjects aged equal to or more than 18 years and involved in MVAs. Conditional logistic regressions with covariates adjustment (including urbanity, psychiatric and non‐psychiatric outpatient visits and Charlson comorbidity score) were applied to examine the effect of four classes of psychotropic drugs on MVAs. Results Significant increased risk of MVAs was found in subjects taking antidepressants within 1 month (adjusted odds ratio (AOR) 1.73, 95% confidence interval (CI) 1.34, 2.22), 1 week (AOR 1.71, 95% CI 1.29, 2.26), and 1 day (AOR 1.70, 95% CI 1.26, 2.29) before MVAs occurred. Similar results were observed in subjects taking benzodiazepines (BZDs) (AOR 1.56, 95% CI 1.38, 1.75 for 1 month; AOR 1.64, 95% CI 1.43, 1.88 for 1 week, and AOR 1.62, 95% CI 1.39, 1.88 for 1 day) and Z‐drugs (AOR 1.42, 95% CI 1.14, 1.76 for 1 month, AOR 1.37, 95% CI 1.06, 1.75 for 1 week, AOR 1.34, 95% CI 1.03, 1.75 for 1 day), but not antipsychotics. Moreover, significant dose effects of antidepressants (equal to or more than 0.6–1.0 DDD), BZDs (equal to or more than 0.1–0.5 DDD) and Z‐drugs (more than 1 DDD) were observed, respectively, on the risk of experiencing an MVA. Conclusion Taken together, subjects taking antidepressants, BZDs and Z‐drugs, separately, should be particularly cautioned for their increasing risk of MVAs.
AbstractList To examine comprehensively the relationship between exposure to four classes of psychotropic drugs including antipsychotics, antidepressants, benzodiazepines (BZDs) and Z-drugs, and motor vehicle accidents (MVAs). The authors conducted a matched case-control study of 5183 subjects with MVAs and 31 093 matched controls, identified from the claims records of outpatient service visits during the period from 2000 to 2009. Inclusion criteria were defined as subjects aged equal to or more than 18 years and involved in MVAs. Conditional logistic regressions with covariates adjustment (including urbanity, psychiatric and non-psychiatric outpatient visits and Charlson comorbidity score) were applied to examine the effect of four classes of psychotropic drugs on MVAs. Significant increased risk of MVAs was found in subjects taking antidepressants within 1 month (adjusted odds ratio (AOR) 1.73, 95% confidence interval (CI) 1.34, 2.22), 1 week (AOR 1.71, 95% CI 1.29, 2.26), and 1 day (AOR 1.70, 95% CI 1.26, 2.29) before MVAs occurred. Similar results were observed in subjects taking benzodiazepines (BZDs) (AOR 1.56, 95% CI 1.38, 1.75 for 1 month; AOR 1.64, 95% CI 1.43, 1.88 for 1 week, and AOR 1.62, 95% CI 1.39, 1.88 for 1 day) and Z-drugs (AOR 1.42, 95% CI 1.14, 1.76 for 1 month, AOR 1.37, 95% CI 1.06, 1.75 for 1 week, AOR 1.34, 95% CI 1.03, 1.75 for 1 day), but not antipsychotics. Moreover, significant dose effects of antidepressants (equal to or more than 0.6-1.0 DDD), BZDs (equal to or more than 0.1-0.5 DDD) and Z-drugs (more than 1 DDD) were observed, respectively, on the risk of experiencing an MVA. Taken together, subjects taking antidepressants, BZDs and Z-drugs, separately, should be particularly cautioned for their increasing risk of MVAs.
To examine comprehensively the relationship between exposure to four classes of psychotropic drugs including antipsychotics, antidepressants, benzodiazepines (BZDs) and Z-drugs, and motor vehicle accidents (MVAs). The authors conducted a matched case-control study of 5183 subjects with MVAs and 31 093 matched controls, identified from the claims records of outpatient service visits during the period from 2000 to 2009. Inclusion criteria were defined as subjects aged equal to or more than 18 years and involved in MVAs. Conditional logistic regressions with covariates adjustment (including urbanity, psychiatric and non-psychiatric outpatient visits and Charlson comorbidity score) were applied to examine the effect of four classes of psychotropic drugs on MVAs. Significant increased risk of MVAs was found in subjects taking antidepressants within 1 month (adjusted odds ratio (AOR) 1.73, 95% confidence interval (CI) 1.34, 2.22), 1 week (AOR 1.71, 95% CI 1.29, 2.26), and 1 day (AOR 1.70, 95% CI 1.26, 2.29) before MVAs occurred. Similar results were observed in subjects taking benzodiazepines (BZDs) (AOR 1.56, 95% CI 1.38, 1.75 for 1 month; AOR 1.64, 95% CI 1.43, 1.88 for 1 week, and AOR 1.62, 95% CI 1.39, 1.88 for 1 day) and Z-drugs (AOR 1.42, 95% CI 1.14, 1.76 for 1 month, AOR 1.37, 95% CI 1.06, 1.75 for 1 week, AOR 1.34, 95% CI 1.03, 1.75 for 1 day), but not antipsychotics. Moreover, significant dose effects of antidepressants (equal to or more than 0.6-1.0 DDD), BZDs (equal to or more than 0.1-0.5 DDD) and Z-drugs (more than 1 DDD) were observed, respectively, on the risk of experiencing an MVA. Taken together, subjects taking antidepressants, BZDs and Z-drugs, separately, should be particularly cautioned for their increasing risk of MVAs.
Aim To examine comprehensively the relationship between exposure to four classes of psychotropic drugs including antipsychotics, antidepressants, benzodiazepines (BZDs) and Z‐drugs, and motor vehicle accidents (MVAs). Method The authors conducted a matched case‐control study of 5183 subjects with MVAs and 31 093 matched controls, identified from the claims records of outpatient service visits during the period from 2000 to 2009. Inclusion criteria were defined as subjects aged equal to or more than 18 years and involved in MVAs. Conditional logistic regressions with covariates adjustment (including urbanity, psychiatric and non‐psychiatric outpatient visits and Charlson comorbidity score) were applied to examine the effect of four classes of psychotropic drugs on MVAs. Results Significant increased risk of MVAs was found in subjects taking antidepressants within 1 month (adjusted odds ratio (AOR) 1.73, 95% confidence interval (CI) 1.34, 2.22), 1 week (AOR 1.71, 95% CI 1.29, 2.26), and 1 day (AOR 1.70, 95% CI 1.26, 2.29) before MVAs occurred. Similar results were observed in subjects taking benzodiazepines (BZDs) (AOR 1.56, 95% CI 1.38, 1.75 for 1 month; AOR 1.64, 95% CI 1.43, 1.88 for 1 week, and AOR 1.62, 95% CI 1.39, 1.88 for 1 day) and Z‐drugs (AOR 1.42, 95% CI 1.14, 1.76 for 1 month, AOR 1.37, 95% CI 1.06, 1.75 for 1 week, AOR 1.34, 95% CI 1.03, 1.75 for 1 day), but not antipsychotics. Moreover, significant dose effects of antidepressants (equal to or more than 0.6–1.0 DDD), BZDs (equal to or more than 0.1–0.5 DDD) and Z‐drugs (more than 1 DDD) were observed, respectively, on the risk of experiencing an MVA. Conclusion Taken together, subjects taking antidepressants, BZDs and Z‐drugs, separately, should be particularly cautioned for their increasing risk of MVAs.
To examine comprehensively the relationship between exposure to four classes of psychotropic drugs including antipsychotics, antidepressants, benzodiazepines (BZDs) and Z-drugs, and motor vehicle accidents (MVAs).AIMTo examine comprehensively the relationship between exposure to four classes of psychotropic drugs including antipsychotics, antidepressants, benzodiazepines (BZDs) and Z-drugs, and motor vehicle accidents (MVAs).The authors conducted a matched case-control study of 5183 subjects with MVAs and 31 093 matched controls, identified from the claims records of outpatient service visits during the period from 2000 to 2009. Inclusion criteria were defined as subjects aged equal to or more than 18 years and involved in MVAs. Conditional logistic regressions with covariates adjustment (including urbanity, psychiatric and non-psychiatric outpatient visits and Charlson comorbidity score) were applied to examine the effect of four classes of psychotropic drugs on MVAs.METHODThe authors conducted a matched case-control study of 5183 subjects with MVAs and 31 093 matched controls, identified from the claims records of outpatient service visits during the period from 2000 to 2009. Inclusion criteria were defined as subjects aged equal to or more than 18 years and involved in MVAs. Conditional logistic regressions with covariates adjustment (including urbanity, psychiatric and non-psychiatric outpatient visits and Charlson comorbidity score) were applied to examine the effect of four classes of psychotropic drugs on MVAs.Significant increased risk of MVAs was found in subjects taking antidepressants within 1 month (adjusted odds ratio (AOR) 1.73, 95% confidence interval (CI) 1.34, 2.22), 1 week (AOR 1.71, 95% CI 1.29, 2.26), and 1 day (AOR 1.70, 95% CI 1.26, 2.29) before MVAs occurred. Similar results were observed in subjects taking benzodiazepines (BZDs) (AOR 1.56, 95% CI 1.38, 1.75 for 1 month; AOR 1.64, 95% CI 1.43, 1.88 for 1 week, and AOR 1.62, 95% CI 1.39, 1.88 for 1 day) and Z-drugs (AOR 1.42, 95% CI 1.14, 1.76 for 1 month, AOR 1.37, 95% CI 1.06, 1.75 for 1 week, AOR 1.34, 95% CI 1.03, 1.75 for 1 day), but not antipsychotics. Moreover, significant dose effects of antidepressants (equal to or more than 0.6-1.0 DDD), BZDs (equal to or more than 0.1-0.5 DDD) and Z-drugs (more than 1 DDD) were observed, respectively, on the risk of experiencing an MVA.RESULTSSignificant increased risk of MVAs was found in subjects taking antidepressants within 1 month (adjusted odds ratio (AOR) 1.73, 95% confidence interval (CI) 1.34, 2.22), 1 week (AOR 1.71, 95% CI 1.29, 2.26), and 1 day (AOR 1.70, 95% CI 1.26, 2.29) before MVAs occurred. Similar results were observed in subjects taking benzodiazepines (BZDs) (AOR 1.56, 95% CI 1.38, 1.75 for 1 month; AOR 1.64, 95% CI 1.43, 1.88 for 1 week, and AOR 1.62, 95% CI 1.39, 1.88 for 1 day) and Z-drugs (AOR 1.42, 95% CI 1.14, 1.76 for 1 month, AOR 1.37, 95% CI 1.06, 1.75 for 1 week, AOR 1.34, 95% CI 1.03, 1.75 for 1 day), but not antipsychotics. Moreover, significant dose effects of antidepressants (equal to or more than 0.6-1.0 DDD), BZDs (equal to or more than 0.1-0.5 DDD) and Z-drugs (more than 1 DDD) were observed, respectively, on the risk of experiencing an MVA.Taken together, subjects taking antidepressants, BZDs and Z-drugs, separately, should be particularly cautioned for their increasing risk of MVAs.CONCLUSIONTaken together, subjects taking antidepressants, BZDs and Z-drugs, separately, should be particularly cautioned for their increasing risk of MVAs.
Author Liang, Hsin‐Yi
Chau, Yeuk‐Lun
Chang, Chia‐Ming
Wu, Chi‐Shin
Tsai, Hui‐Ju
Wu, Kuan‐Yi
Chen, Chuan‐Yu
Lin, Keh‐Ming
Wu, Erin Chia‐Hsuan
Author_xml – sequence: 1
  givenname: Chia‐Ming
  surname: Chang
  fullname: Chang, Chia‐Ming
  organization: Lin‐Kou & Chang Gung University
– sequence: 2
  givenname: Erin Chia‐Hsuan
  surname: Wu
  fullname: Wu, Erin Chia‐Hsuan
  organization: Taipei Medical University
– sequence: 3
  givenname: Chuan‐Yu
  surname: Chen
  fullname: Chen, Chuan‐Yu
  organization: National Yang‐Ming University
– sequence: 4
  givenname: Kuan‐Yi
  surname: Wu
  fullname: Wu, Kuan‐Yi
  organization: Lin‐Kou & Chang Gung University
– sequence: 5
  givenname: Hsin‐Yi
  surname: Liang
  fullname: Liang, Hsin‐Yi
  organization: Lin‐Kou & Chang Gung University
– sequence: 6
  givenname: Yeuk‐Lun
  surname: Chau
  fullname: Chau, Yeuk‐Lun
  organization: Lin‐Kou & Chang Gung University
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  givenname: Chi‐Shin
  surname: Wu
  fullname: Wu, Chi‐Shin
  organization: Far Eastern Memorial Hospital
– sequence: 8
  givenname: Keh‐Ming
  surname: Lin
  fullname: Lin, Keh‐Ming
  organization: National Health Research Institutes
– sequence: 9
  givenname: Hui‐Ju
  surname: Tsai
  fullname: Tsai, Hui‐Ju
  organization: National Health Research Institutes
BackLink https://www.ncbi.nlm.nih.gov/pubmed/22971090$$D View this record in MEDLINE/PubMed
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2012 The Authors. British Journal of Clinical Pharmacology © 2012 The British Pharmacological Society.
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Snippet Aim To examine comprehensively the relationship between exposure to four classes of psychotropic drugs including antipsychotics, antidepressants,...
To examine comprehensively the relationship between exposure to four classes of psychotropic drugs including antipsychotics, antidepressants, benzodiazepines...
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Publisher
StartPage 1125
SubjectTerms Accidents, Traffic
Adolescent
Adult
Aged
antidepressants
Antidepressive Agents - adverse effects
Antipsychotic Agents - adverse effects
antipsychotics
benzodiazepines
Benzodiazepines - adverse effects
Case-Control Studies
Databases, Factual
Dose-Response Relationship, Drug
Female
Humans
Hypnotics and Sedatives - adverse effects
Male
Middle Aged
motor vehicle accidents
Pharmacoepidemiology
psychotropic drugs
Taiwan
Z‐drugs
Title Psychotropic drugs and risk of motor vehicle accidents: a population‐based case‐control study
URI https://onlinelibrary.wiley.com/doi/abs/10.1111%2Fj.1365-2125.2012.04410.x
https://www.ncbi.nlm.nih.gov/pubmed/22971090
https://www.proquest.com/docview/1317849887
https://www.proquest.com/docview/1367483716
https://pubmed.ncbi.nlm.nih.gov/PMC3612731
Volume 75
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