Driving drugs affecting performance

ICADTS (2006). Catergtorization System for Medicinal Drugs Affecting Driving Performance. International Council on Accidents Drugs and Driving. http //www.icadts.org/reports/medicinaldrugsl.pdf... 

Monitoring Effectiveness for more than 3 to 4 weeks has not been demonstrated in controlled trials. However, patients have been treated for a year without ill effect. If used for extended periods, periodically reassess the usefulness of the drug. interference with cognitive and motor performance Buspirone is less sedating than other anxiolytics and does not produce significant functional impairment. However, its CNS effect may not be predictable. Therefore, caution patients about driving or using complex machinery until they are certain that buspirone does not affect them adversely. 

MAOIs affect psychomotor performance driving and operating machinery is not advised. Abrupt termination of antidepressants, including MAOIs, causes severe adverse effects. Symptoms may be treated by gradually withdrawing these drugs.142... 

Several studies have found that cannabis and alcohol produce additive detrimental effects on driving performance, but other studies have failed to show any potentiation. This is probably due to the variety of simulated driving tests used and possibly the time lag between the administration of alcohol and cannabis behavioural impairment after cannabis has been reported to peak within 30 minutes of smoking. Nevertheless, both drugs have been shown to affect some aspects of driving performance and increase the risk of fatal car accidents. Concurrent use of cannabis and alcohol before driving should therefore be avoided. 

The case reports of adverse interactions cited here appear to be isolated, and it is by no means certain that all the responses were in fact due to drug interactions. However, bear them in mind in the event of unexpected responses to treatment. No special precautions would normally be required during concurrent use, although a reminder that benzodiazepines may affect the performance of skilled tasks, such as driving, may be appropriate when a patient s medication is changed. Note that the manufacturer of moclobemide says that if depressed patients with excitation or agitation are first treated with moclobemide, a sedative such as a benzodiazepine should also be given for up to 2 to 3 weeks. Further study is required to find out if there are any clinically important pharmacokinetic interactions between moclobemide and any of the benzodiazepines. 

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