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Prescription of antidepressants and the risk of road traffic crash in the elderly: a case–crossover study
Author(s) -
Orriols Ludivine,
Wilchesky Machelle,
Lagarde Emmanuel,
Suissa Samy
Publication year - 2013
Publication title -
british journal of clinical pharmacology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.216
H-Index - 146
eISSN - 1365-2125
pISSN - 0306-5251
DOI - 10.1111/bcp.12090
Subject(s) - crash , medicine , medical prescription , crossover study , poison control , antidepressant , depression (economics) , injury prevention , emergency medicine , psychiatry , pharmacology , alternative medicine , anxiety , computer science , economics , macroeconomics , programming language , pathology , placebo
Aim To investigate the impact of antidepressants on the risk of road traffic crash in the elderly. Methods Reports from the U niversal Q uebec A utomobile I nsurance A gency database were matched with data on antidepressant prescription from the Q uebec H ealth I nsurance A gency. The case–crossover analysis consisted in comparing exposure during a period immediately before the crash with exposure during earlier periods, for the same subject. Results One hundred and nine thousand four hundred and six drivers between 66 and 84 years of age involved in a traffic crash between 1988 and 2000 were included. Two thousand nine hundred and nineteen (2.7%) were exposed to an antidepressant on the day of the crash. Case–crossover analysis found an increased risk of crash in drivers with a prescription of antidepressants before their crash when compared with a prescription of antidepressants 4 to 8 months before the crash ( OR = 1.19, 95% CI 1.08, 1.30 to 1.42. 95% CI 1.30, 1.55). With the most recent control periods, results were not significant. Conclusion A patient's mental state is probably more similar between two periods that are close to each other than up to 8 months before. Consequently, the risk of crash is likely to be linked to symptoms of depression.