{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,5]],"date-time":"2026-09-05T00:00:13Z","timestamp":1788566413408,"version":"build-2803163510"},"reference-count":68,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2021,5,26]],"date-time":"2021-05-26T00:00:00Z","timestamp":1621987200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,9,21]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Mobility is important for daily life functioning, with particular challenges regarding road safety under pharmacological treatment in patients with a psychiatric disease.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>According to PRISMA guidelines, a systematic literature search on PubMed database (January 1970 to December 2020) was performed. Primary endpoints were driving performance in on-road tests, driving simulator performance, or psychomotor and visual perception functions assessed to estimate fitness to drive according to legal regulations in patient studies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Forty studies were identified (1533 patients, 38% female, median age 45 years), of which more than 60% were cross-sectional and open-label trials. Under steady-state medication, 31% (range 27%\u201342.5%) of schizophrenic or schizoaffective patients under antipsychotics and 18% (range 16%\u201320%) of unipolar and bipolar patients under antidepressants showed severe impairment in skills relevant for driving. Data point to an advantage of second-generation antipsychotics compared with first-generation antipsychotics as well as modern antidepressants over tricyclic antidepressants with respect to driving. Most patients significantly improved or stabilized in driving skills within 2\u20134 weeks of treatment with non-sedative or sedative antidepressants. Diazepam significantly worsened driving the first 3 weeks after treatment initiation, whereas medazepam (low dose), temazepam, and zolpidem did not impair driving. In long-term users of sedating antidepressants or benzodiazepines, impairments in on-road tests were not evident.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The available evidence suggests that psychopharmacologic medicines improve or at least stabilize driving performance of patients under long-term treatment when given on clinical considerations. To enhance treatment compliance, existing classification systems of medicinal drugs concerning impact on driving performance should also incorporate information about effects of long-term-treatment.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ijnp\/pyab031","type":"journal-article","created":{"date-parts":[[2021,5,25]],"date-time":"2021-05-25T07:12:12Z","timestamp":1621926732000},"page":"679-693","source":"Crossref","is-referenced-by-count":20,"title":["Driving Performance Under Treatment of Most Frequently Prescribed Drugs for Mental Disorders: A Systematic Review of Patient Studies"],"prefix":"10.1093","volume":"24","author":[{"given":"Alexander","family":"Brunnauer","sequence":"first","affiliation":[{"name":"kbo-Inn-Salzach-Klinikum, Clinical Center for Psychiatry, Psychotherapy, Psychosomatic Medicine, Geriatrics and Neurology, Wasserburg\/Inn, Germany"},{"name":"Department of Psychiatry and Psychotherapy, Ludwig-Maximilians University, Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florian","family":"Herpich","sequence":"additional","affiliation":[{"name":"kbo-Inn-Salzach-Klinikum, Clinical Center for Psychiatry, Psychotherapy, Psychosomatic Medicine, Geriatrics and Neurology, Wasserburg\/Inn, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Zwanzger","sequence":"additional","affiliation":[{"name":"kbo-Inn-Salzach-Klinikum, Clinical Center for Psychiatry, Psychotherapy, Psychosomatic Medicine, Geriatrics and Neurology, Wasserburg\/Inn, Germany"},{"name":"Department of Psychiatry and Psychotherapy, Ludwig-Maximilians University, Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerd","family":"Laux","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Psychotherapy, Ludwig-Maximilians University, Munich, Germany"},{"name":"Institute of Psychological Medicine (IPM) Soyen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2021,5,26]]},"reference":[{"key":"2021092108145096200_CIT0001","doi-asserted-by":"crossref","first-page":"1331","DOI":"10.1016\/S0140-6736(98)04087-2","article-title":"Association of road-traffic accidents with benzodiazepine use","volume":"352","author":"Barbone","year":"1998","journal-title":"Lancet"},{"key":"2021092108145096200_CIT0002","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1016\/j.psychres.2014.05.013","article-title":"Pharmacological and non-pharmacological interventions to improve cognitive dysfunction and functional ability in clinical depression\u2013a systematic review","volume":"219","author":"Baune","year":"2014","journal-title":"Psychiatry Res"},{"key":"2021092108145096200_CIT0003","volume-title":"Meta-analysis of empirical studies concerning the effects of medicines and illegal drugs including pharmacokinetics on safe driving","author":"Berghaus","year":"2010"},{"key":"2021092108145096200_CIT0004","doi-asserted-by":"crossref","first-page":"1099","DOI":"10.4088\/JCP.v69n0709","article-title":"Minor increase in risk of road traffic accidents after prescriptions of antidepressants: a study of population registry data in Norway","volume":"69","author":"Bramness","year":"2008","journal-title":"J Clin Psychiatry"},{"key":"2021092108145096200_CIT0005","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1007\/BF02657065","article-title":"Repeated dose effects of lormetazepam and flurazepam upon driving performance","volume":"39","author":"Brookhuis","year":"1990","journal-title":"Eur J Clin Pharmacol"},{"key":"2021092108145096200_CIT0006","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1055\/s-0034-1398509","article-title":"Driving performance and psychomotor function in depressed patients treated with agomelatine or venlafaxine","volume":"48","author":"Brunnauer","year":"2015","journal-title":"Pharmacopsychiatry"},{"key":"2021092108145096200_CIT0007","doi-asserted-by":"crossref","first-page":"40","DOI":"10.3109\/13651501.2015.1089293","article-title":"Mobility behaviour and driving status of patients with mental disorders - 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