This report summarises the known effects of prescribed psychotropic drugs on road crash risk. A thorough review of the published literature both in Australia and abroad is presented. Benzodiazepines, antidepressants, opiates and antipsychotics are specifically examined. General drug class effects and evidence from experimental and epidemiological studies are discussed and deficiencies in the current literature highlighted. The primary findings are: (1) alcohol remains the most powerful risk factor for road crashes; (2) combinations of drugs with alcohol are commonly encountered; (3) benzodiazepines are generally associated with a small but significant increase in crash risk, particularly those with long half-lives; (4) this risk is highest in the first four weeks after commencing a benzodiazepine; (5) tricyclic antidepressants and opiates have occasionally been associated with an elevated crash risk; (6) polydrug use is relatively common in road crash drivers. Recommendations based on this review include: (1) public health efforts should continue to focus on reducing drink driving; (2) health care professionals when prescribing psychotropics should caution patients regarding the potential for driving impairment, especially when initiating treatment; (3) further research is required to clarify the role of prescribed psychotropics in road crashes. (Author/publisher)
Samenvatting