Association of road-traffic accidents with benzodiazepine use
Association of road-traffic accidents with benzodiazepine use
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DOI：
10.1016/s0140-6736(98)04087-2
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发表时间：
1998-10-24
期刊：
影响因子：
168.9
通讯作者：
MacDonald, TM
中科院分区：
文献类型：
--
作者：
Barbone, F;McMahon, AD;MacDonald, TM
背景精神病学研究表明，常用的精神活性药物损害驾驶技能。我们研究了精神活性药物的使用和道路交通事故之间的关联。方法我们使用处方药作为一项人内病例交叉研究中的暴露措施，研究对象为18岁及以上的驾驶员，居住在英国泰赛德，他们在1992年8月1日至1995年6月30日期间经历了第一次道路交通事故，并使用了精神活性药物（三环类抗抑郁药、苯二氮卓类、选择性阿托宁再摄取抑制剂或其他精神活性药物[主要是主要镇静剂]）。对于每个司机，有一个道路交通事故的风险，而暴露和不暴露于drugs.Findings 19 386司机参与了第一次道路交通事故在研究期间。1731人使用任何研究药物。事故发生当天，189人正在服用三环类抗抑郁药（事故的患者内暴露比值比0.93 [95% CI 0.72-1.21]），84例选择性降钙素再摄取抑制剂苯二氮卓类药物235例（1.62 [1.24-2.12]），其他精神活性药物47例（0.88 [0.62-1.25]）。与苯二氮卓类药物使用相关的风险随着驾驶员年龄的增加而降低，当酒精呼气测试呈阳性时，风险更大。与苯二氮卓类药物存在明显的剂量-反应关系。苯二氮卓类药物的风险增加对于长半衰期药物（用作抗焦虑药）和短半衰期催眠药（所有佐匹克隆）均显著。解释抗焦虑苯二氮卓类药物和佐匹克隆使用者发生道路交通事故的风险增加。应建议抗焦虑苯二氮卓类药物和佐匹克隆使用者不要开车。
Background Psychomotor studies suggest that commonly prescribed psychoactive drugs impair driving skills. We have examined the association between the use of psychoactive drugs and road-traffic accidents.Methods We used dispensed prescribing as a measure of exposure in a within-person case-crossover study of drivers aged 18 years and over, resident in Tayside, UK, who experienced a first road-traffic accident between Aug 1, 1992, and June 30, 1995, and had used a psychoactive drug (tricyclic antidepressant, benzodiazepine, selective serotonin-reuptake inhibitor, or other psychoactive drug [mainly major tranquillisers]) between Aug 1, 1992, and the date of the accident. For each driver, the risks of having a road-traffic accident while exposed and not exposed to a drug were compared.Findings 19 386 drivers were involved in a first road-traffic accident during the study period. 1731 were users of any study drug. On the day of the accident, 189 individuals were taking tricyclic antidepressants (within-patient exposure odds ratio for an accident 0.93 [95% CI 0.72-1.21]), 84 selective serotonin-reuptake inhibitors (0.85 [0.55-1.33]), 235 benzodiazepines (1.62 [1.24-2.12]), and 47 other psychoactive drugs (0.88 [0.62-1.25]). The risk associated with benzodiazepine use decreased with increasing driver's age and was greater when the breath test for alcohol was positive. A dose-response relation was evident with benzodiazepines. The increased risk with benzodiazepines was significant for long-half-life drugs, used as anxiolytics, and for short-half-life hypnotics (all zopiclone).Interpretation Users of anxiolytic benzodiazepines and zopiclone were at increased risk of experiencing a road-traffic accident. Users of anxiolytic benzodiazepines and zopiclone should be advised not to drive.