Antidepressants and Driving Ability

Depression is a mental disorder that is likely to affect daily functions, including driving ability. However, driving performance of depressed patients remains poorly investigated. We will present 2 studies designed to assess driving performance of patients receiving long-term antidepressant treatment. The first study compared driving performance of untreated depressed patients, depressed patients receiving SSRI or SNRI treatment for 6–52 weeks and matched healthy controls. The second study compared driving performance of long-term users of sedative antidepressants to that of matched healthy controls. A standardized on-the-road driving test was used to assess standard deviation of lateral position (SDLP), a measure of weaving. In the first study, mean SDLP of untreated and treated patients were significantly higher as compared to SDLP of matched controls. Driving impairment in the treated group was significantly less as compared to the untreated group. SDLP was positively correlated to severity of depression across both groups of patients. In the second study, SDLP of patients receiving sedative antidepressants (e.g. mirtazapine) during 0,5–3 yrs was significantly higher as compared to matched controls. Driving performance of patients receiving sedative antidepressants for more than 3 yrs did not differ from matched controls. Severity of depression in these patients groups was low. It is concluded that symptoms of depression are a major cause of driving impairment. Reductions in severity of depression through antidepressant treatment reduce severity of driving impairment. Sedative antidepressants such as mirtazapine however can still induce driving impairment in patients with remission for up to 3 yrs of use.Disclosure of interestThe work presented was funded by the Dutch ministry of Infrastructure and transport and the European Committee.

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Driving Performance of Depressed Patients who are Untreated or Receive Long-Term Antidepressant (SSRI/SNRI) Treatment

Pharmacopsychiatry ◽

10.1055/s-0043-111600 ◽

2017 ◽

Vol 50 (05) ◽

pp. 182-188 ◽

Cited By ~ 8

Author(s):

Nick van der Sluiszen ◽

Marleen Wingen ◽

Annemiek Vermeeren ◽

Frederick Vinckenbosch ◽

Stefan Jongen ◽

...

Keyword(s):

Rating Scale ◽

Antidepressant Treatment ◽

Driving Performance ◽

Healthy Controls ◽

Depressed Patients ◽

Driving Impairment ◽

Patient Groups ◽

Severity Of Depression ◽

On The Road

Abstract Introduction Depression is a mental disorder likely to affect everyday functions. The present study aimed to assess actual driving performance of depressed patients who were without specific antidepressant treatment or received long-term antidepressant treatment. Methods A standardized on-the-road driving test was used to assess standard deviation of lateral position (SDLP) in 3 patient groups receiving either no antidepressant treatment (with or without benzodiazepine medication) or treatment with selective serotonin/noradrenalin reuptake inhibitors for a period of 6–52 weeks. Severity of depression was assessed using Beck’s Depression Inventory and the Hamilton Depression Rating Scale. The performance of patient groups was compared to healthy controls. Results The mean SDLP of untreated and treated patients was significantly higher than that of healthy controls. Driving impairment in the long-term treated group was significantly less than in the untreated groups. SDLP was positively correlated to severity of depression across all groups. Discussion It is concluded that symptoms of depression are a major cause of driving impairment. Reductions in severity of depression through antidepressant treatment reduce severity of driving impairment.

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Driving impairment in depressed patients receiving long-term antidepressant treatment

Psychopharmacology ◽

10.1007/s00213-006-0471-7 ◽

2006 ◽

Vol 188 (1) ◽

pp. 84-91 ◽

Cited By ~ 43

Author(s):

Marleen Wingen ◽

Johannes G. Ramaekers ◽

Jeroen A. J. Schmitt

Keyword(s):

Antidepressant Treatment ◽

Depressed Patients ◽

Driving Impairment

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Association Between BDNF Gene Variant Rs6265 and the Severity of Depression in Antidepressant Treatment-Free Depressed Patients

Frontiers in Psychiatry ◽

10.3389/fpsyt.2020.00038 ◽

2020 ◽

Vol 11 ◽

Cited By ~ 3

Author(s):

Innokentiy S. Losenkov ◽

Nathaniël J. V. Mulder ◽

Lyudmila A. Levchuk ◽

Natalya M. Vyalova ◽

Anton J. M. Loonen ◽

...

Keyword(s):

Antidepressant Treatment ◽

Gene Variant ◽

Bdnf Gene ◽

Depressed Patients ◽

Severity Of Depression

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Assessing the links between childhood trauma, C-reactive protein and response to antidepressant treatment in patients with affective disorders

European Archives of Psychiatry and Clinical Neuroscience ◽

10.1007/s00406-021-01245-z ◽

2021 ◽

Author(s):

Kai F. Fischer ◽

Maria S. Simon ◽

Julie Elsner ◽

Johanna Dobmeier ◽

Johannes Dorr ◽

...

Keyword(s):

Depressive Symptoms ◽

Treatment Response ◽

Childhood Trauma ◽

Bipolar Depression ◽

Antidepressant Treatment ◽

The Body ◽

Healthy Controls ◽

C Reactive Protein ◽

Reactive Protein ◽

Depressed Patients

AbstractAdverse Childhood Experiences (ACE) are a well-known risk-factor for depression. Additionally, (high-sensitive) C-reactive Protein (hsCRP) is elevated in subgroups of depressed patients and high following ACE. In this context the literature considers hsCRP and ACE to be associated with treatment resistant depression. With the data being heterogenous, this study aimed to explore the associations of ACE, hsCRP levels and response to antidepressant treatment in uni- and bipolar depression. N = 76 patients diagnosed with uni- or bipolar depression and N = 53 healthy controls were included. Treatment was over 6 weeks in an inpatient psychiatric setting within an observatory study design. Depressive symptoms were assessed by the Montgomery-Asberg Depression Rating Scale (MADRS), ACE were assessed by the Childhood Trauma Questionnaire (CTQ); the body-mass-index (BMI) and hsCRP were measured. HsCRP levels did not differ between the study population and the healthy controls. While the depressive symptoms decreased, the hsCRP levels increased. Sexual abuse was associated with significant higher and emotional abuse with lower levels of hsCRP after 6 weeks. The baseline hsCRP levels and the ACE subgroups did not show significant associations with the treatment response in unipolar depressed patients. The long-lasting effects of specific forms of ACE may have relevant impact on inflammation, supporting hsCRP to be a suitable biomarker. With ACE and hsCRP not showing any significant associations with treatment response in the unipolar depressed subgroup, a more differentiate research concerning biomarkers and treatment regimens is needed when talking about treatment response.

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The Incidence, Clinical Significance, and Treatment Effects of Depression in Cardiac Resynchronization Therapy Recipients

Cardiology ◽

10.1159/000475522 ◽

2017 ◽

Vol 138 (2) ◽

pp. 115-121

Author(s):

Tomasz Podolecki ◽

Robert Pudlo ◽

Michal Mazurek ◽

Monika Koziel ◽

Ewa Jedrzejczyk-Patej ◽

...

Keyword(s):

Cardiac Resynchronization Therapy ◽

Antidepressant Treatment ◽

Treated Group ◽

Cardiac Resynchronization ◽

Control Group ◽

Resynchronization Therapy ◽

Cardiac Events ◽

Depression Group ◽

Observational Group

Objectives: Chronic heart failure (HF) is associated with significantly increased prevalence of depression. The aim of the study was to assess the incidence and clinical impact of depression as well as the effectiveness of depression treatment in HF patients. Methods: A prospective interventional trial included 285 consecutive cardiac resynchronization therapy recipients. Patients underwent a psychiatric examination at the time of implantation and then it was routinely repeated at 3, 6, and 12 months after the procedure, and every 6 months thereafter. One hundred and thirty-five (47.4%) patients with depression were included in the depression group, whereas the control group was comprised of 150 patients free of depression. Sixty-eight (50.4%) subjects received antidepressants (treated group), whereas the observational group had 67 (49.6%) depressed patients who refused to take antidepressants. Results: Depression remission was achieved in 51 (75.0%) patients from the treated group. Long-term mortality and HF hospitalization rates were significantly higher in the depression group than in the control group (20.7 vs. 11.3% and 32.6 vs. 19.2%, respectively). However, remission from depression was associated with a 40% reduction in the relative risk of major adverse cardiac events (MACE). Conclusions: Patients with HF and concomitant depression are at higher risk of MACE compared with those free of depression. Effective antidepressant treatment may significantly improve long-term outcomes in this population.

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Driving Under the Influence of Antidepressants: A Systematic Review and Update of the Evidence of Experimental and Controlled Clinical Studies

Pharmacopsychiatry ◽

10.1055/s-0043-113572 ◽

2017 ◽

Vol 50 (05) ◽

pp. 173-181 ◽

Cited By ~ 5

Author(s):

Alexander Brunnauer ◽

Gerd Laux

Keyword(s):

Clinical Studies ◽

Selective Serotonin Reuptake Inhibitors ◽

Antidepressant Treatment ◽

Driving Performance ◽

Driving Under The Influence ◽

Driving Ability ◽

Driving Skills ◽

Pubmed Database ◽

Repeated Dosing ◽

Patient Studies

Abstract Introduction This review provides an update of experimental and clinical studies on the effects of antidepressants on driving performance. Methods A systematic literature search on the PubMed database (1980–2016) was performed. Results Twenty-eight studies could be included in this review, whereas only 5 studies investigated driving performance under antidepressants in patients. Most tri- and tetracyclics have acute deleterious effects on driving performance that, except for mianserin, attenuate after subchronic use. Selective serotonin reuptake inhibitors and the serotonin norepinephrine reuptake inhibitor’s venlafaxine and milnacipran did not affect driving ability. Trazodone appears to have dose-related acute effects on driving skills. Acute use of mirtazapine does produce impairments that diminish when given as a nocturnal dose and cannot be seen in healthy subjects when initially given as a low dose or after repeated dosing. Additive effects with alcohol were most pronounced with sedating antidepressants. Most patients definitely benefit from treatment with newer antidepressants with respect to driving skills. Discussion Much more patient studies are needed to elucidate a crucial question: from which antidepressant treatment do patients benefit most with respect to driving performance?

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Aberrant Expression of Intracellular let-7e, miR-146a, and miR-155 Correlates with Severity of Depression in Patients with Major Depressive Disorder and Is Ameliorated after Antidepressant Treatment

Cells ◽

10.3390/cells8070647 ◽

2019 ◽

Vol 8 (7) ◽

pp. 647 ◽

Cited By ~ 9

Author(s):

Yi-Yung Hung ◽

Ming-Kung Wu ◽

Meng-Chang Tsai ◽

Ya-Ling Huang ◽

Hong-Yo Kang

Keyword(s):

Major Depressive Disorder ◽

Depressive Disorder ◽

Rating Scale ◽

Antidepressant Treatment ◽

Healthy Controls ◽

Major Depressive ◽

Aberrant Expression ◽

Tlr4 Signaling ◽

Before And After ◽

Severity Of Depression

Chronic inflammation and abnormalities in Toll-like receptor (TLR) signaling pathways are associated with major depressive disorder (MDD). Our previous work reported that impaired negative regulators for the TLR pathways are associated with MDD. This study aimed to assess the association between the severity of depression and the intracellular microRNAs that regulate TLR4 signaling in both peripheral blood mononuclear cells (PBMCs) and monocytes from MDD patients. The severity of MDD before and after antidepressant treatment was determined by the 17-item Hamilton Depression Rating Scale, and quantitative RT-PCR was used to measure the levels of intracellular regulatory microRNAs, including let-7e, miR-21-5p miR-145, miR-223, miR-146a, and miR-155, in PBMCs and monocytes isolated from 43 healthy controls and 84 patients with MDD before and after treatment with antidepressants. Assays of PBMCs showed that the levels of let-7e, miR-146a, and miR-155 were lower in MDD patients than in healthy controls and were significantly higher after than before treatment in the 69 patients who completed treatment with antidepressants for four weeks. Levels of miR-146a and miR-155 in monocytes were lower in MDD patients than in controls and were increased in the former after antidepressant treatment. Multiple linear regression analyses found that let-7e and miR-146a expression before treatment was inversely correlated with severity of depression, whereas miR-155 before treatment was directly correlated with severity of depression. These findings suggest that intracellular regulatory microRNAs which regulate TLR4 signaling are aberrantly expressed in patients with MDD and that these levels are ameliorated by antidepressant treatment.

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Insulin-induced hypoglycaemic response and release of growth hormone in depressed patients and healthy controls

Psychological Medicine ◽

10.1017/s0033291700001914 ◽

1988 ◽

Vol 18 (1) ◽

pp. 79-91 ◽

Cited By ~ 8

Author(s):

David J. Brunswick ◽

Alan Frazer ◽

Stephen H. Koslow ◽

Regina Casper ◽

Peter E. Stokes ◽

...

Keyword(s):

Growth Hormone ◽

Collaborative Study ◽

Female Group ◽

Healthy Controls ◽

Exclusion Criteria ◽

Glucose Response ◽

Depressed Patients ◽

Weak Association ◽

Total Female ◽

Severity Of Depression

SynopsisAs part of the Collaborative Study of the Psychobiology of Depression, we have examined the pretreatment growth hormone response (ΔGH) to insulin (0·1 U/kg) and the magnitude of the hypoglycaemic response in a large number of well-defined depressed patients (N = 132) and healthy controls (N = 80). After applying rigorous exclusion criteria, data were analysed from 93 patients and 66 controls for blood glucose response and from 56 patients and 52 controls for ΔGH. Depressed patients, either unipolar or bipolar, showed less of a fall in glucose than controls. A weak association was found between the magnitude of the fall in glucose and the severity of depression. No significant differences were found in values for ΔGH between the unipolar or bipolar depressed patients and controls either for males, pre-menopausal or postmenopausal females, or the total female group. These data do not support previous claims of a lowered ΔGH response to insulin in depressed patients. However, the resistance to hypoglycaemia seen in the depressed patients is consistent with previous reports.

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