Psychotropic Medications Increase the Risk of Motor Vehicle Accidents
We are clearly a society that relies on the use medications and drugs. Look in your medicine cabinet. How many medications do you find? Aspirin? Acid blockers? Allergy medications? Blood pressure medications? Antidepressants? Anti-anxiety drugs? Do you drink coffee or caffeinated sodas? Do you drink alcohol? Drug use is pervasive.
Indeed, we have become so enamored with drugs that we often forget that many human problems are better treated with nonpharmacological methods. Furthermore, aging increases drug accumulation over time and increases the risk of toxicity from medications and drugs. A single class of medications; psychotropics that are used to manage conditions like anxiety, depression, and lack of sleep; is used by as many as 40-50% of those who are aged, by some estimates. The use of psychotropics is greater among the aged than the young despite the fact that mental illness is much less likely in the elderly than in the young. Additionally, more than 50% of the elderly take psychotropics for 6 months or longer).
Psychotropic drugs (and alcohol) impair cognitive (e.g., memory, induce confusion) and motor (e.g., induce falls, slow thinking and reaction time) in everyone. These effects as well as delirium are more likely as we age. A recent study raises questions regarding the impact of use of psychotropics on the prevalence of motor vehicle accidents.
We have known for some time that use of medications like Valium/diazepam, Klonopin/clonazepam, Xanax/alprazolam, Ativan/lorazepam increase the risk of accidents while driving. These are the class of medications known as benzodiazepines. Long acting benzodiazepines (e.g., Valium, Klonopin) were believed to be more problematic than short acting (e.g., Xanax, Ativan) and those given for anxiety were believed to be problematic while those given for sleep (e.g., Restoril/temazepam) were not seen as increasing driving risk.
A new study (British Journal of Clinical Pharmacology, 2012, September 12) reveals that anyone taking benzodiazepines (long acting, short acting anxiolytics or hypnotics), antidepressants (either older generation like Elavil/amitriptyline or newer generation like Prozac/fluoxetine), or hypnotics such as Ambien/zolpidem (called “Z” drugs) is at increased risk for motor vehicle accidents. Interestingly, there was no significant increase in motor vehicle accidents for those taking antipsychotic drugs (either older generation medications like Haldol/haloperidol or newer generation medications like Seroquel/quetiapine.
There is no simple solution to this problem. Psychotropic medications are useful in managing distress. However, we have to assess the risks and benefits from these medications better. We need to consider several questions related to use of medications in driving in particular but for our lives in general. Are many of the bad effects of psychotropics due to an interaction with alcohol? Alcohol potentiates the effects of these medications and many drink when taking them. We may underestimate the effects of prescribed medications as consumers because they are given by prescription and therefore must be “safe.” We have not addressed the effects of multiple medications or their chronic use.
Psychotropic medications reduce anxiety and depression and help induce sleep. However, they don’t teach skills or coping behaviors. We need to realize that better living takes more than altering our chemistry. Better living requires effort, planning, and constant learning.
Join Dr. Beckwith for a free webinar sponsored by Ciccarelli Advisory Services on December 11 at 3:30. Call (239) 262-6577 or e-mail firstname.lastname@example.org to register.