Leo Sher, M.D.

A meta-analysis, “Depression, antidepressants and driving safety” was published in Injury Epidemiology in 2017 (1). The purpose of this study was to review the reported associations of depression and antidepressants with motor vehicle crashes.

This paper included epidemiologic studies published in English between January 1995 and October 2015. Retrieved articles were systematically reviewed for inclusion criteria: 19 epidemiological studies (17 case-control and 2 cohort studies) fulfilled the inclusion criteria by estimating the crash risk associated with depression and/or psychotropic medications in naturalistic settings.

The estimates of the odds ratio (OR) of crash involvement associated with depression ranged from 1.78 to 3.99. All classes of antidepressants were reported to have side effects with the potential to affect driving safety. The majority of studies of antidepressant effects on driving reported an elevated crash risk, and ORs ranged from 1.19 to 2.03 for all crashes, and 3.19 for fatal crashes. In meta-analysis, depression was associated with approximately 2-fold increased crash risk (summary OR = 1.90; 95% CI, 1.06 to 3.39), and antidepressants were associated with approximately 40% increased crash risk (summary OR = 1.40; 95%CI, 1.18 to 1.66).

In summary, the studies reviewed, conducted mainly in developed countries, found associations between depression and crashes. Though estimates are hampered by the variation in study population and study design, depression was generally found to approximately double the risk of crash. Antidepressants have potentially conflicting contributions to motor vehicle crashes in relieving the effects of depression and suicide while posing side effects that may affect driving. Based on the findings of the studies reviewed, depression, antidepressants or the combination of depression and antidepressants may pose a potential hazard to driving safety.

Reference

1. Hill LL, Lauzon VL, Winbrock EL, Li G, Chihuri S, Lee KC. Depression, antidepressants and driving safety. Inj Epidemiol. 2017 Dec;4(1):10. doi: 10.1186/s40621-017-0107-x. Epub 2017 Apr 3.