Prescription of antidepressants and the risk of road traffic crash in the elderly: A case-crossover study

Abstract

Aim: To investigate the impact of antidepressants on the risk of road traffic crash in the elderly. Methods: Reports from the Universal Quebec Automobile Insurance Agency database were matched with data on antidepressant prescription from the Quebec Health Insurance Agency. The case-crossover analysis consisted in comparing exposure during a period immediately before the crash with exposure during earlier periods, for the same subject. Results: One hundred and nine thousand four hundred and six drivers between 66 and 84 years of age involved in a traffic crash between 1988 and 2000 were included. Two thousand nine hundred and nineteen (2.7%) were exposed to an antidepressant on the day of the crash. Case-crossover analysis found an increased risk of crash in drivers with a prescription of antidepressants before their crash when compared with a prescription of antidepressants 4 to 8 months before the crash (OR = 1.19, 95% CI 1.08, 1.30 to 1.42. 95% CI 1.30, 1.55). With the most recent control periods, results were not significant. Conclusion: A patient's mental state is probably more similar between two periods that are close to each other than up to 8 months before. Consequently, the risk of crash is likely to be linked to symptoms of depression. © 2013 The British Pharmacological Society.