Road traffic accidents and psychotropic medication use in The Netherlands: a case-control study

Br J Clin Pharmacol. 2011 Sep;72(3):505-13. doi: 10.1111/j.1365-2125.2011.03994.x.


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.

MeSH terms

  • Accidents, Traffic / statistics & numerical data*
  • Adolescent
  • Adult
  • Age Distribution
  • Aged
  • Aged, 80 and over
  • Alcohol Drinking / adverse effects*
  • Anti-Anxiety Agents / therapeutic use*
  • Automobile Driving
  • Case-Control Studies
  • Databases, Factual
  • Dose-Response Relationship, Drug
  • Drug Utilization / statistics & numerical data
  • Female
  • Humans
  • Hypnotics and Sedatives / therapeutic use*
  • Male
  • Middle Aged
  • Netherlands
  • Psychotropic Drugs / therapeutic use*
  • Regression Analysis
  • Risk Factors
  • Young Adult


  • Anti-Anxiety Agents
  • Hypnotics and Sedatives
  • Psychotropic Drugs