Road traffic accidents and psychotropic medication use in the Netherlands: a case–control study


Professor Lolkje T. W. de Jong-van den Berg, Department of Pharmacoepidemiology and Pharmacoeconomics, University of Groningen, Antonius Deusinglaan 1, 9713 AV Groningen, the Netherlands. Tel.: +31 (0)50 363 33 30, Fax: +31 (0)50 363 27 72. E-mail:



• Some psychotropic medications (e.g. benzodiazepines, sedative antidepressants, etc.) can impair cognitive and psychomotor functions and, therefore, endanger traffic safety.

• There is a lack of knowledge concerning the role in traffic safety of first and new generations of psychotropic medications, new and chronic users, young and old drivers, and polypharmacy.


• There is an increased risk of having a traffic accident after being exposed to some psychotropic medicine classes and, in particular, to SSRIs.

• Health care professionals and patients should be properly informed about the potential effects of some psychoactive medications on driving abilities.

• The role of SSRIs in traffic safety has to be investigated further.

AIM To examine the association between the use of commonly prescribed psychotropic medications and road traffic accident risk.

METHODS A record-linkage database was used to perform a case–control study in the Netherlands. The data came from three sources: pharmacy prescription data, police traffic accident data and driving licence data. Cases were defined as drivers, who had a traffic accident that required medical assistance between 2000 and 2007. Controls were defined as adults, who had a driving licence and had no traffic accident during the study period. Four controls were matched for each case. The following psychotropic medicine groups were examined: antipsychotics, anxiolytics, hypnotics and sedatives, and antidepressants stratified in the two groups, SSRIs and other antidepressants. Various variables, such as age, gender, medicine half-life and alcohol use, were considered for the analysis.

RESULTS Three thousand nine hundred and sixty-three cases and 18 828 controls were included in the case–control analysis. A significant association was found between traffic accident risk and exposure to anxiolytics (OR = 1.54, 95% CI 1.11, 2.15), and SSRIs (OR = 2.03, 95% CI 1.31, 3.14). A statistically significant increased risk was also seen in chronic anxiolytic users, females and young users (18 to 29 years old), chronic SSRI users, females and middle-aged users (30 to 59 years old), and intermediate half-life hypnotic users.

CONCLUSIONS The results of this study support previous findings and confirm that psychoactive medications can constitute a problem in traffic safety. Both health care providers and patients should be properly informed of the potential risks associated with the use of these medicines.