Driving performance and neurocognitive skills of long-term users of sedating antidepressants

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

*Corresponding author for this work

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Objective To assess driving performance and neurocognitive skills of long-term users of sedating antidepressants, in comparison to healthy controls. Methods Thirty-eight long-term (>6 months) users of amitriptyline (n= 13) and mirtazapine (n= 25) were compared to 65 healthy controls. Driving performance was assessed using a 1-h standardised highway driving test in actual traffic, with road-tracking error (standard deviation of lateral position [SDLP]) being the primary measure. Secondary measures included neurocognitive tasks related to driving. Performance differences between groups were compared to those of blood alcohol concentrations of 0.5 mg/ml to determine clinical relevance. Results Compared to controls, mean increase in SDLP of all antidepressant users was not significant, nor clinically relevant (+0.75 cm, 95% CI: -0.83 cm; +2.33 cm). However, users treated less than 3 years (n= 20) did show a significant and clinically relevant increase in SDLP (+2.05 cm). No significant effects were observed on neurocognitive tasks for any user group, although large individual differences were present. Most results from neurocognitive tests were inconclusive, while a few parameters confirmed non-inferiority for users treated longer than 3 years. Conclusion The impairing effects of antidepressant treatment on driving performance and neurocognition mitigate over time following long-term use of 3 years.

Original languageEnglish
Article number2762
Number of pages12
JournalHuman Psychopharmacology
Issue number1
Publication statusPublished - Jan-2021


  • antidepressants
  • driving performance
  • long-term use
  • neurocognition
  • on-the-road driving
  • ROAD
  • RISK
  • PAIN

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