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首页> 外文期刊>The journal of clinical psychiatry >Antidepressants and Driver Impairment: Empirical Evidence From a Standard On-the-Road Test.
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Antidepressants and Driver Impairment: Empirical Evidence From a Standard On-the-Road Test.

机译：抗抑郁药和驾驶员损伤：来自标准道路测试的经验证据。

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BACKGROUND AND METHOD: The current review summarizes the major results from all published studies from 1983 to 2000 (9 double-blind, crossover, placebo-controlled studies in healthy volunteers and 1 double-blind, baseline-controlled study in patients) that have determined the effects of antidepressants on actual driving performance using a standard test. That test measures driving impairment from vehicular "weaving" (i.e., standard deviation of lateral position [SDLP]) during 1 hour of on-the-road driving in normal traffic. RESULTS: Changes in SDLP after acute doses of sedating antidepressants (i.e., amitriptyline, imipramine, doxepin, and mianserin) were comparable to those seen in drivers conducting the same test with a blood alcohol concentration of 0.8 mg/mL or more. Driving performance of subjects returned to placebo levels after 1 week of treatment, except after treatment with mianserin, for which the impairing effect lasted unabated over treatment. Nocturnal doses of sedating antidepressants (i.e., dothiepin, mianserin, and mirtazapine), however, did not produce residual driving impairment when measured the next day. Nonsedating antidepressants (i.e., moclobemide, fluoxetine, paroxetine, venlafaxine, and nefazodone) generally did not affect SDLP. However, SDLP rose to unacceptable levels after administration of combinations of nonsedating antidepressants and benzodiazepines with incompatible pharmacokinetic profiles. Correlational analyses demonstrated that conventional tests of psychomotor performance or self-ratings of side effects did not strongly predict antidepressant effects on SDLP. Regression analysis revealed a strong linear relation between antidepressant effects in the standard driving test and the number of patients reporting somnolence in clinical trials with the same antidepressants. CONCLUSION: Application of actual driving tests remains essential to conclusively defining the potential hazard of drugs for driving.
机译：背景与方法：本综述总结了1983年至2000年所有已发表研究的主要结果（9项健康志愿者的双盲，交叉，安慰剂对照研究和1例患者的双盲，基线对照研究），这些研究已确定使用标准测试，抗抑郁药对实际驾驶性能的影响。该测试用于测量正常交通中行驶1小时时车辆“编织”造成的驾驶损伤（即侧向位置标准偏差[SDLP]）。结果：急性剂量的镇静抗抑郁药（即阿米替林，丙咪嗪，多塞平和米安色林）服用后，SDLP的变化与进行相同测试的血液酒精浓度为0.8 mg / mL或更高的驾驶员相当。在治疗1周后，受试者的驾驶表现恢复至安慰剂水平，除了用棉塞林治疗后，其损害作用持续超过治疗。夜间服用的镇静抗抑郁药（即多西平，米安色林和米氮平）在第二天测量时并未产生残留的驾驶障碍。非镇静抗抑郁药（即莫氯贝米，氟西汀，帕罗西汀，文拉法辛和奈法唑酮）通常不会影响SDLP。然而，在非镇静抗抑郁药和苯二氮卓类药物的药代动力学特征不相容的情况下，SDLP上升至不可接受的水平。相关分析表明，常规的心理运动表现测试或副作用自我评估不能强烈预测对SDLP的抗抑郁作用。回归分析显示，标准驾驶考试中的抗抑郁作用与在临床试验中使用相同抗抑郁药报告嗜睡的患者人数之间存在很强的线性关系。结论：实际驾驶测试的应用对于确定药物对驾驶的潜在危害至关重要。

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