Research on this article is taken from “Medications and Impaired Driving: A Review of the Literature,” found in the U.S. National Library of Medicine.
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Research on this article is taken from “Medications and Impaired Driving: A Review of the Literature,” found in the U.S. National Library of Medicine.
DIPHENHYDRAMINE
In a controlled trial, subjects with a blood alcohol content (BAC) one-eighth the legal limit were able to better steer a vehicle simulator than subjects given 50 mg of diphenhydramine.
DIAZEPAM
In a study of elderly Medicaid enrollees, the risk of motor vehicle crash was increased with BZD use but was even greater for subjects taking diazepam in excess of 20 mg per day.
BZD USE
While LeRoy and Morse show that BZD use corresponds to double the risk of a motor vehicle crash, further studies have shown that these agents cause measurable impairments in cognitive and motor function as well.
THE DANGEROUS 3
Zolpidem, zaleplon, and eszopiclone have been around since the 1990s and have become a popular alternative to BZDs in managing sleep disorders. They still may produce dizziness and drowsiness and were shown to increase the collision rate by 48% in the LeRoy and Morse study.
ZOLPIDEM
The literature has associated zolpidem with both at-fault and non-at-fault collisions. The risk of motor vehicle accidents appears to be greater in patients prescribed more than one 10 mg tablet per day.
IMPAIRMENT VS. CRASH RISK
Ultimately, the literature designates no impairment with zaleplon, no impairment with eszopiclone in patients with insomnia, and an increased crash risk overall with the use of zolpidem.
SLEEP ANALYSIS
Tricyclic antidepressants (TCAs) are still prescribed for neuropathic pain, certain anxieties, and menopausal symptoms. LeRoy and Morse found a 41% greater crash likelihood with the use of TCAs.
MIRTAZAPINE
In a crossover trial comparing mirtazapine with placebo, driving performance was affected during the initial treatment period (days 1 to 7) with a lower 30 mg dose.