An explorative approach to understanding individual differences in driving performance and neurocognition in long-term benzodiazepine users

Frederick R. J. Vinckenbosch*, Annemiek Vermeeren, Eric F. P. M. Vuurman, Nick N. J. J. M. van der Sluiszen, Joris C. Verster, Aurora J. A. E. van de Loo, Joke H. van Dijken, Janet L. Veldstra, Karel A. Brookhuis, Dick de Waard, Johannes G. Ramaekers

*Corresponding author for this work

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Abstract

Objective: Previous research reported cognitive and psychomotor impairments in long‐term users of benzodiazepine receptor agonists (BZRAs). This article explores the role of acute intoxication and clinical complaints.
Methods: Neurocognitive and on‐road driving performance of 19 long‐term (≥6 months) regular (≥twice weekly) BZRA users with estimated plasma concentrations, based on self‐reported use, exceeding the therapeutic threshold (CBZRA+), and 31 long‐term regular BZRA users below (CBZRA−), was compared to that of 76 controls.
Results: BZRA users performed worse on tasks of response speed, processing
speed, and sustained attention. Age, but not CBZRA or self‐reported clinical
complaints, was a significant covariate. Road‐tracking performance was explained by CBZRA only. The CBZRA + group exhibited increased mean standard deviation of lateral position comparable to that at blood‐alcohol concentrations of 0.5 g/L.
Conclusions: Functional impairments in long‐term BZRA users are not attributable to self‐reported clinical complaints or estimated BZRA concentrations, except for road‐tracking, which was impaired in CBZRA + users. Limitations to address are the lack of assessment of objective clinical complaints, acute task related stress, and actual BZRA plasma concentrations. In conclusion, the results confirm previous findings that demonstrate inferior performance across several psychomotor and neurocognitive domains in long‐term BZRA users.
Original languageEnglish
Article numbere2778
Number of pages17
JournalHuman Psychopharmacology
Volume36
Issue number4
DOIs
Publication statusPublished - Jul-2021

Keywords

  • benzodiazepines, benzodiazepine receptor agonists, long‐term use, neurocognition, on‐road driving, psychomotor functioning

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