Limited contribution of long‐term psychotropics to driving impairment

2021 ◽  
Vol 33 (1) ◽  
pp. 8-8
Keyword(s):  
Driving Impairment

Driving impairment in depressed patients receiving long-term antidepressant treatment

2006 ◽  
Vol 188 (1) ◽  
pp. 84-91 ◽  
Author(s):  
Marleen Wingen ◽  
Johannes G. Ramaekers ◽  
Jeroen A. J. Schmitt
Keyword(s):  
Antidepressant Treatment ◽  
Depressed Patients ◽  
Driving Impairment

Antidepressants and Driving Ability

2017 ◽  
Vol 41 (S1) ◽  
pp. S50-S51 ◽  
Author(s):  
J. Ramaekers
Keyword(s):  
Antidepressant Treatment ◽  
Treated Group ◽  
Driving Performance ◽  
Driving Ability ◽  
Healthy Controls ◽  
Depressed Patients ◽  
Driving Impairment ◽  
Severity Of Depression ◽  
On The Road

Depression is a mental disorder that is likely to affect daily functions, including driving ability. However, driving performance of depressed patients remains poorly investigated. We will present 2 studies designed to assess driving performance of patients receiving long-term antidepressant treatment. The first study compared driving performance of untreated depressed patients, depressed patients receiving SSRI or SNRI treatment for 6–52 weeks and matched healthy controls. The second study compared driving performance of long-term users of sedative antidepressants to that of matched healthy controls. A standardized on-the-road driving test was used to assess standard deviation of lateral position (SDLP), a measure of weaving. In the first study, mean SDLP of untreated and treated patients were significantly higher as compared to SDLP of matched controls. Driving impairment in the treated group was significantly less as compared to the untreated group. SDLP was positively correlated to severity of depression across both groups of patients. In the second study, SDLP of patients receiving sedative antidepressants (e.g. mirtazapine) during 0,5–3 yrs was significantly higher as compared to matched controls. Driving performance of patients receiving sedative antidepressants for more than 3 yrs did not differ from matched controls. Severity of depression in these patients groups was low. It is concluded that symptoms of depression are a major cause of driving impairment. Reductions in severity of depression through antidepressant treatment reduce severity of driving impairment. Sedative antidepressants such as mirtazapine however can still induce driving impairment in patients with remission for up to 3 yrs of use.Disclosure of interestThe work presented was funded by the Dutch ministry of Infrastructure and transport and the European Committee.

scholarly journals Is suvorexant a better choice than alternative hypnotics?

F1000Research ◽  
2015 ◽  
Vol 4 ◽  
pp. 456 ◽  
Author(s):  
Daniel F. Kripke
Keyword(s):  
Sleep Onset ◽  
Premature Death ◽  
Phase Iii ◽  
Daytime Somnolence ◽  
Driving Impairment ◽  
Incident Cancer ◽  
Phase Iii Trials ◽  
Safety Considerations ◽  
Slow Absorption

Suvorexant is a novel dual orexin receptor antagonist (DORA) newly introduced in the U.S. as a hypnotic, but no claim of superiority over other hypnotics has been offered.  The manufacturer argued that the 5 and 10 mg starting doses recommended by the FDA might be ineffective.  The manufacturer's main Phase III trials had not even included the 10 mg dosage, and the 5 mg dosage had not been tested at all in registered clinical trials at the time of approval.  Popular alternative hypnotics may be similarly ineffective, since the FDA has also reduced the recommended doses for zolpidem and eszopiclone.  The "not to exceed" suvorexant dosage of 20 mg does slightly increase sleep.  Because of slow absorption, suvorexant has little effect on latency to sleep onset but some small effect in suppressing wakening after sleep onset and in improving sleep efficiency. The FDA would not approve the manufacturer's preferred 40 mg suvorexant dosage, because of concern with daytime somnolence, driving impairment, and possible narcolepsy-like symptoms.  In its immediate benefits-to-risks ratio, suvorexant is unlikely to prove superior to currently available hypnotics—possibly worse—so there is little reason to prefer over the alternatives this likely more expensive hypnotic less-tested in practice.  Associations are being increasingly documented relating hypnotic usage with incident cancer, with dementia risks, and with premature death.  There is some basis to speculate that suvorexant might be safer than alternative hypnotics in terms of cancer, dementia, infections, and mortality.  These safety considerations will remain unproven speculations unless adequate long-term trials can be done that demonstrate suvorexant advantages.

Driving Performance of Depressed Patients who are Untreated or Receive Long-Term Antidepressant (SSRI/SNRI) Treatment

2017 ◽  
Vol 50 (05) ◽  
pp. 182-188 ◽  
Author(s):  
Nick van der Sluiszen ◽  
Marleen Wingen ◽  
Annemiek Vermeeren ◽  
Frederick Vinckenbosch ◽  
Stefan Jongen ◽  
...  
Keyword(s):  
Rating Scale ◽  
Antidepressant Treatment ◽  
Driving Performance ◽  
Healthy Controls ◽  
Depressed Patients ◽  
Driving Impairment ◽  
Patient Groups ◽  
Severity Of Depression ◽  
On The Road

Abstract Introduction Depression is a mental disorder likely to affect everyday functions. The present study aimed to assess actual driving performance of depressed patients who were without specific antidepressant treatment or received long-term antidepressant treatment. Methods A standardized on-the-road driving test was used to assess standard deviation of lateral position (SDLP) in 3 patient groups receiving either no antidepressant treatment (with or without benzodiazepine medication) or treatment with selective serotonin/noradrenalin reuptake inhibitors for a period of 6–52 weeks. Severity of depression was assessed using Beck’s Depression Inventory and the Hamilton Depression Rating Scale. The performance of patient groups was compared to healthy controls. Results The mean SDLP of untreated and treated patients was significantly higher than that of healthy controls. Driving impairment in the long-term treated group was significantly less than in the untreated groups. SDLP was positively correlated to severity of depression across all groups. Discussion It is concluded that symptoms of depression are a major cause of driving impairment. Reductions in severity of depression through antidepressant treatment reduce severity of driving impairment.

Therapy and prevention for mental health: What if mental diseases are mostly not brain disorders?

2019 ◽  
Vol 42 ◽  
Author(s):  
John P. A. Ioannidis
Keyword(s):  
Mental Health ◽  
Mental Disease ◽  
Brain Disorders ◽  
Social Stressors ◽  
Labor Education ◽  
Mental Diseases ◽  
Long Term Follow Up ◽  
Political Decisions

AbstractNeurobiology-based interventions for mental diseases and searches for useful biomarkers of treatment response have largely failed. Clinical trials should assess interventions related to environmental and social stressors, with long-term follow-up; social rather than biological endpoints; personalized outcomes; and suitable cluster, adaptive, and n-of-1 designs. Labor, education, financial, and other social/political decisions should be evaluated for their impacts on mental disease.

Conceptual short-term memory (CSTM) supports core claims of Christiansen and Chater

2016 ◽  
Vol 39 ◽  
Author(s):  
Mary C. Potter
Keyword(s):  
Working Memory ◽  
Rapid Serial Visual Presentation ◽  
Language Comprehension ◽  
Short Term Memory ◽  
Visual Presentation ◽  
Long Term Memory ◽  
Short Term ◽  
Term Memory ◽  
Use Of Knowledge

AbstractRapid serial visual presentation (RSVP) of words or pictured scenes provides evidence for a large-capacity conceptual short-term memory (CSTM) that momentarily provides rich associated material from long-term memory, permitting rapid chunking (Potter 1993; 2009; 2012). In perception of scenes as well as language comprehension, we make use of knowledge that briefly exceeds the supposed limits of working memory.

Brief summary of Kleť photographic search programme for minor planets

1999 ◽  
Vol 173 ◽  
pp. 189-192
Author(s):  
J. Tichá ◽  
M. Tichý ◽  
Z. Moravec
Keyword(s):  
Ccd Camera ◽  
Minor Planet ◽  
Minor Planets ◽  
Main Belt

AbstractA long-term photographic search programme for minor planets was begun at the Kleť Observatory at the end of seventies using a 0.63-m Maksutov telescope, but with insufficient respect for long-arc follow-up astrometry. More than two thousand provisional designations were given to new Kleť discoveries. Since 1993 targeted follow-up astrometry of Kleť candidates has been performed with a 0.57-m reflector equipped with a CCD camera, and reliable orbits for many previous Kleť discoveries have been determined. The photographic programme results in more than 350 numbered minor planets credited to Kleť, one of the world's most prolific discovery sites. Nearly 50 per cent of them were numbered as a consequence of CCD follow-up observations since 1994.This brief summary describes the results of this Kleť photographic minor planet survey between 1977 and 1996. The majority of the Kleť photographic discoveries are main belt asteroids, but two Amor type asteroids and one Trojan have been found.

Evolution of Large-Scale Coronal Structures

1994 ◽  
Vol 144 ◽  
pp. 29-33
Author(s):  
P. Ambrož
Keyword(s):  
Magnetic Field ◽  
Field Line ◽  
Large Scale ◽  
Coronal Magnetic Field ◽  
Source Surface ◽  
Solar Cycles ◽  
Characteristic Relationship ◽  
The Magnetic Field ◽  
Coronal Structures

AbstractThe large-scale coronal structures observed during the sporadically visible solar eclipses were compared with the numerically extrapolated field-line structures of coronal magnetic field. A characteristic relationship between the observed structures of coronal plasma and the magnetic field line configurations was determined. The long-term evolution of large scale coronal structures inferred from photospheric magnetic observations in the course of 11- and 22-year solar cycles is described.Some known parameters, such as the source surface radius, or coronal rotation rate are discussed and actually interpreted. A relation between the large-scale photospheric magnetic field evolution and the coronal structure rearrangement is demonstrated.

Long-term Cyclic Variations of Prominences, Green and Red Coronae over Solar Cycles

2000 ◽  
Vol 179 ◽  
pp. 201-204
Author(s):  
Vojtech Rušin ◽  
Milan Minarovjech ◽  
Milan Rybanský
Keyword(s):  
Emission Lines ◽  
High Latitudes ◽  
Green Line ◽  
Solar Cycles ◽  
The South ◽  
Coronal Emission ◽  
Local Maxima ◽  
The North ◽  
Cyclic Variations

AbstractLong-term cyclic variations in the distribution of prominences and intensities of green (530.3 nm) and red (637.4 nm) coronal emission lines over solar cycles 18–23 are presented. Polar prominence branches will reach the poles at different epochs in cycle 23: the north branch at the beginning in 2002 and the south branch a year later (2003), respectively. The local maxima of intensities in the green line show both poleward- and equatorward-migrating branches. The poleward branches will reach the poles around cycle maxima like prominences, while the equatorward branches show a duration of 18 years and will end in cycle minima (2007). The red corona shows mostly equatorward branches. The possibility that these branches begin to develop at high latitudes in the preceding cycles cannot be excluded.

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