Driving Performance and Psychomotor Function in Depressed Patients Treated with Agomelatine or Venlafaxine

 

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Abstract

Objective: We conducted a randomized case-control study in depressive inpatients to assess the effects of agomelatine and venlafaxine on psychomotor functions related to driving skills and on driving performance in an on-road driving test.

Method: 40 depressed inpatients treated with agomelatine (n=20) or venlafaxine (n=20) were tested before pharmacological treatment (t₀), and on days 14 (t₁) and 28 (t₂). 20 healthy subjects were examined in the same time schedule to control for retest effects in psychomotor measures. Additionally, participants were rated in a standardized on-road driving test on day 28 by a licensed driving instructor, who was blind with respect to treatment, diagnosis and test results.

Results: After 4 weeks of treatment (t₂) with agomelatine or venlafaxine, patients showed a significant reduction in depressive symptoms, and a distinct improvement in psychomotor functions. Controlling for retest effects in psychomotor measures, data indicate, that both patient groups significantly improved in tests measuring reactivity and stress-tolerance. Furthermore, prior discharge to outpatient treatment (day 28), 72.5% of patients were labeled abundantly fit to drive in the on-road driving test by a licensed driving instructor. However, patients did not reach the performance level of healthy controls in functional domains tested. Significant differences between treatment groups were not observed.

Conclusion: Our results indicate that depressed inpatients treated with agomelatine or venlafaxine show a better test performance on tasks related to driving skills than do untreated depressives and could predominantly be rated as fit to drive on an actual driving test prior discharge to outpatient treatment.

• References

• 1 Brunnauer A, Laux G, Zwick S et al. Mobility behaviour of patients with mental illness. Nervenheilkunde 2008; 27 (Suppl. 01) 120-121
  PubMedGoogle Scholar
• 2 Möller HJ. Are all antidepressants the same?. J Clin Psychiatry 2000; 61 (Suppl. 06) 24-28
  PubMedGoogle Scholar
• 3 Anderson IM. Selective serotonin reuptake inhibitors versus tricyclic antidepressants: a meta-analysis of efficacy and tolerability. J Affect Disord 2000; 58: 19-36
  CrossrefPubMedGoogle Scholar
• 4 Barbone F, McMahon AD, Davey PG et al. Association of road traffic accidents with benzodiazepine use. Lancet 1998; 352: 1331-1336
  Google Scholar
• 5 Gibson JE, Hubbard RB, Smith CJ et al. Use of self controlled analytical techniques to assess the association between use of prescription medications and the risk of motor vehicle crashes. Am J Epidemiol 2009; 169: 761-768
  CrossrefPubMedGoogle Scholar
• 6 Bramness JG, Skurtveit S, Neutel CI et al. Minor increase in risk of road traffic accidents after prescriptions of antidepressants: A study of population registry data in Norway. J Clin Psychiatry 2008; 69: 1099-1103
  CrossrefPubMedGoogle Scholar
• 7 Ravera S, van Rein N, de Gier J et al. Road traffic accidents and psychotropic medication use in the Netherlands: a case-control study. Br J Clin Pharmacol 2011; 72: 505-513
  CrossrefPubMedGoogle Scholar
• 8 Ray WA, Fought RL, Decker MD. Psychoactive drugs and the risk of injurious motor vehicle crashes in elderly drivers. Am J Epidemiol 1992; 136: 873-883
  CrossrefPubMedGoogle Scholar
• 9 Leveille SG, Buchner DM, Koepsell TD et al. Psychoactive medications and injurious motor vehicle collisions involving older drivers. Epidemiology 1994; 5: 591-598
  CrossrefPubMedGoogle Scholar
• 10 Ramaekers JG. Antidepressants and driver impairment: empirical evidence from a standard on-the-road test. J Clin Psychiat 2003; 64: 20-29
  CrossrefPubMedGoogle Scholar
• 11 Brunnauer A, Laux G. The effects of most commonly prescribed second generation antidepressants on driving ability: a systematic review. J Neural Transm 2013; 1: 225-232
  PubMedGoogle Scholar
• 12 Kasper S, Hamon M. Beyond the monoaminergic hypothesis: agomelatin, a new antidepressant with an innovative mechanism of action. World J. Biol Psychiatry 2009; 10: 117-126
  CrossrefPubMedGoogle Scholar
• 13 O’Hanlon JF, Robbe HWJ, Vermeeren A et al. Venlafaxine’s effects on healthy volunteers’ driving, psychomotor, and vigilance performance during 15-day fixed and incremental dosing regimens. J Clin Psychopharmacol 1998; 18: 212-221
  CrossrefPubMedGoogle Scholar
• 14 Laredo J, Quera Salva MA, Falissard B et al. Screening of sleep and circadian rhythms in major depression: Sleep an wake complaints. J Sleep Res 2002; 11 (Suppl. 01) 132-133
  PubMedGoogle Scholar
• 15 Karner T, Biehl B. Über die Zusammenhänge verschiedener Versionen von Leistungstests im Rahmen der verkehrspsychologischen Diagnostik. Z Verkehrssicherheit 2001; 47: 53-63
  PubMedGoogle Scholar
• 16 Brunnauer A, Laux G, David I et al. The impact of reboxetine and mirtazapine on driving simulator performance and psychomotor function in depressed patients. J Clin Psychiatry 2008; 69: 1880-1886
  CrossrefPubMedGoogle Scholar
• 17 Brunnauer A, Laux G, Geiger E et al. Antidepressants and driving ability: results from a clinical study. J Clin Psychiatry 2006; 67: 1776-1781
  Google Scholar
• 18 Soyka M. Opioids and traffic safety – focus on buprenorphine. Pharmacopsychiatry 2014; 47: 7-17
  Article in Thieme ConnectPubMedGoogle Scholar
• 19 Gunja N. In the Zzz zone: The effects of Z-drugs on human performance and driving. J Med Toxicol 2013; 163-171
  PubMedGoogle Scholar
• 20 Dassaynake T, Michie P, Carter G et al. Effects of benzodiazepines, antidepressants and opioids on driving: a systematic review and meta-analysis of experimental and experimental evidence. Drug Saf 2011; 34: 125-156
  CrossrefPubMedGoogle Scholar
• 21 Schulze H, Schumacher M, Urmeev R et al. 2012 DRUID 6^th Framework Programme. Deliverable 0.1.8. Final Report: Work performed main results and recommendations. http://www.druidproject.eu/Druid/EN/Dissemination/downloads_and_links/Final_Report.html?nn=613800 (zuletzt zugegriffen am 28.11.2014)
  PubMedGoogle Scholar
• 22 Schwabe U, Paffrath D (Hrsg). Arzneiverordnungsreport Aktuelle Daten, Kosten, Trends und Kommentare. Heidelberg: Springer Verlag; 2014
  Google Scholar
• 23 Shen J, Moller HJ, Wang X et al. Mirtazapine, a sedating antidepressant, and improved driving safety in patients with major depressive disorder: a prospective, randomized trial of 28 patients. J Clin Psychiatry 2009; 70: 370-377
  CrossrefPubMedGoogle Scholar
• 24 Wingen M, Ramaekers JG, Schmitt JA. Driving impairment in depressed patients receiving long-term antidepressant treatment. Psychopharmacology 2006; 188: 84-91
  CrossrefPubMedGoogle Scholar
• 25 Siepmann T, Mueck-Weimann M, Oertel R et al. The effects of venlafaxine on cognitive function and quantitative EEG in healthy volunteers. Pharmacopsychiatry 2008; 41: 146-150
  Article in Thieme ConnectPubMedGoogle Scholar
• 26 Trick L, Stanley N, Rigney U et al. A double-blind randomized 26-week study comparing the cognitive and psychomotor effects and efficacy of 75 mg (37.5 mg b. i. d.) venlafaxine and 75mg (25mg mane and 50 mg nocte) dothiepin in elderly patients with moderate major depression treated in general practice. J Psychopharmacol 2004; 18: 205-214
  CrossrefPubMedGoogle Scholar
• 27 O’Hanlon JF, Robbe HWJ, Vermeeren A et al. Venlafaxine’s effects on healthy volunteers’ driving, psychomotor, and vigilance performance during 15-day fixed and incremental dosing regimens. J Clin Psychopharmacol 1998; 18: 212-221
  CrossrefPubMedGoogle Scholar
• 28 Bruno A, Mico U, Lorusso S et al. Agomelatine in the treatment of fibromyalgia. A 12-week open-label, uncontrolled preliminary study. J Clin Psychopharmacol 2013; 33: 507-511
  CrossrefPubMedGoogle Scholar
• 29 Brunnauer A, Laux G. Driving ability and antidepressants. Psychiat Prax 2003; 30 (Supplement 2) 102-105
  Article in Thieme ConnectPubMedGoogle Scholar
• 30 Grabe HJ, Wolf T, Grätz S et al. The influence of polypharmacological antidepressant treatment on central nervous information processing of depressed patients: Implications for fitness to drive. Neuropsychobiology 1998; 37: 200-204
  Google Scholar