2010 BC Guide in Determining Fitness to Drive

AntiepilepticsIn general, individuals with epilepsy have an increased risk for adverse driving outcomes, whichmay be caused by either the episodic impairment (seizures) or persistent impairments caused bythe condition or treatment.AntihistaminesResearch indicates that the use of older antihistamines may impair driving performance.However, newer antihistamines used in therapeutic doses do not appear to increase the risk ofadverse driving outcomes.AntipsychoticsStudies examining the driving performance of individuals treated with antipsychotics (primarilythose with Schizophrenia) indicate that those treated with atypical antipsychotics perform betterthan those treated with typical antipsychotics. However, less than 33% of those on atypicalantipsychotics and 5% to 11% of those on typical antipsychotics were found to have adequatedriving performance. It should be noted that these results are based on functional tests conductedin a laboratory setting, and the relationship of these results to actual driving performance has notbeen established. Further, it is difficult to determine the relative impact of the underlyingcondition and antipsychotic treatment on driving performance.Non-steroidal anti-inflammatoriesThere is only a small body of literature related to the effects of NSAIDs on driving performance.These studies indicate that the use of NSAIDs is associated with an increased risk of crash inboth young and old drivers.Sedatives and hypnoticsResearch indicates that the use of sedatives and hypnotics is associated with a significant risk foradverse driving outcomes.Stimulants (for ADHD)There is some indication that pharmacological treatment of ADHD with stimulants may have apositive effect on driving performance. However, research in this area has primarily relied ondriving simulators to measure outcomes. A few studies have investigated the relationshipbetween pharmacological treatment of ADHD and on-road performance, but methodologicallimitations, including small sample size (< 20 in all cases), limit the findings.359