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Pharmacopsychiatry 2017; 50(05): 173-181
DOI: 10.1055/s-0043-113572
Review
© Georg Thieme Verlag KG Stuttgart · New York

Driving Under the Influence of Antidepressants: A Systematic Review and Update of the Evidence of Experimental and Controlled Clinical Studies

Alexander Brunnauer
1   kbo-Inn-Salzach-Klinikum, Psychiatric Hospital, Wasserburg/Inn, Germany
2   Department of Psychiatry and Psychotherapy, Ludwig-Maximilians University, Munich, Germany
,
Gerd Laux
2   Department of Psychiatry and Psychotherapy, Ludwig-Maximilians University, Munich, Germany
3   Institute of Psychological Medicine (IPM) Soyen, Germany
› Institutsangaben
Weitere Informationen

Publikationsverlauf

received 20. März 2017
revised 05. Juni 2017

accepted 07. Juni 2017

Publikationsdatum:
17. Juli 2017 (online)

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Abstract

Introduction This review provides an update of experimental and clinical studies on the effects of antidepressants on driving performance.

Methods A systematic literature search on the PubMed database (1980–2016) was performed.

Results Twenty-eight studies could be included in this review, whereas only 5 studies investigated driving performance under antidepressants in patients. Most tri- and tetracyclics have acute deleterious effects on driving performance that, except for mianserin, attenuate after subchronic use. Selective serotonin reuptake inhibitors and the serotonin norepinephrine reuptake inhibitor’s venlafaxine and milnacipran did not affect driving ability. Trazodone appears to have dose-related acute effects on driving skills. Acute use of mirtazapine does produce impairments that diminish when given as a nocturnal dose and cannot be seen in healthy subjects when initially given as a low dose or after repeated dosing. Additive effects with alcohol were most pronounced with sedating antidepressants. Most patients definitely benefit from treatment with newer antidepressants with respect to driving skills.

Discussion Much more patient studies are needed to elucidate a crucial question: from which antidepressant treatment do patients benefit most with respect to driving performance?

Key words

antidepressants - depression - driving performance
 

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