Risk of injurious road traffic crash after prescription of antidepressants

Abstract

Objective: To estimate the risk of road traffic crash associated with prescription of antidepressants.

Method: Data were extracted and matched from 3 French national databases: the national health care insurance database, police reports, and the national police database of injurious crashes. A case-control analysis comparing 34,896 responsible versus 37,789 nonresponsible drivers was conducted. Case-crossover analysis was performed to investigate the acute effect of medicine exposure.

Results: 72,685 drivers, identified by their national health care number, involved in an injurious crash in France from July 2005 to May 2008 were included. 2,936 drivers (4.0%) were exposed to at least 1 antidepressant on the day of the crash. The results showed a significant association between the risk of being responsible for a crash and prescription of antidepressants (odds ratio [OR] = 1.34; 95% CI, 1.22-1.47). The case-crossover analysis showed no association with treatment prescription, but the risk of road traffic crash increased after an initiation of antidepressant treatment (OR = 1.49; 95% CI, 1.24-1.79) and after a change in antidepressant treatment (OR = 1.32; 95% CI, 1.09-1.60).

Conclusions: Patients and prescribers should be warned about the risk of crash during periods of treatment with antidepressant medication and about particularly high vulnerability periods such as those when a treatment is initiated or modified.