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新研究结果显示，合并严重忧郁症与使用抗忧郁药物可能会使驾驶能力受损。
这项研究发表于美国精神医学会第116届年会，来自北达科塔大学的研究者们发现，相较于罹患轻微忧郁症且服用抗忧郁药物的病患，罹患严重忧郁症的个体，使用抗忧郁药物会降低专注力并延缓驾驶座反应时间。
除此之外，罹患轻度忧郁症的研究受试者，使用抗忧郁药物与正常控制组受试者的表现没有差异。
主要研究者Holly Dannewitz博士向Medscape精神医学表示，这些发现显示，高忧郁指数与使用抗忧郁药物似乎会赋予双重厄运，因此有这样组合的受试者，在开车时专注力与反应时间显著地较差。
【研究结果不一】
根据Dannewitz博士表示，少数小型研究结果显示，部分抗忧郁药物会负面地影响个体认知表现，使记忆受损与反应时间延长。然而，她附带表示，其他研究结果显示，抗忧郁药物治疗对于认知功能没有影响。
为了进一步探索这些药物对于认知功能的潜在影响，特别是驾驶表现，研究者收纳了60位受试者，31位至少使用一种以上的抗忧郁药物，与29位相对应控制组，控制组受试者并没有服用药物，除了某些例外有服用口服避孕药物。
为了决定忧郁症严重度与使用药物资讯，所有受试者都填写贝克忧郁目录第二版（BDI-II），沮丧病史评估问卷与一份医疗史相关问卷。
使用抗忧郁药物的受试者被进一步分为两组，一组BDI-II平均分数为0~12，其他人BDI-II平均分数为14~39。
受试者参与电脑驾驶模拟，以评估驾驶能力，特别是操作、扫描与专注。在完成驾驶练习后，每位受试者各自完成4圈的测试。驾驶训练是最简单的，而最后1圈距离最远，且需要更多的反应力。
驾驶模拟评估两项任务的反应时间，分别是周边与中枢任务。中枢任务需要受试者对煞车警示灯踩下煞车，而周边任务则是需要受试者对停车标记或是交通号志做出踩油门的反应。
【并不需要驾驶禁令】
有趣的是，Dannewitz博士表示，这两组之间操控与追踪能力并没有差异。然而，更微妙的测量是，忧郁指数较高受试者的反应时间是否较长。
Danneqitz博士指出，虽然忧郁指数较高且使用抗忧郁药物的个体表现地比其他两组差，但受损程度并未严重到需要对这些个体发出驾驶禁令。
她表示，无论如何，有此类病患的医师，应该注意病患的驾驶能力，与其他需要最佳专注力及快速反应时间功能的受损。
后续的研究需要厘清情绪或使用药物为造成这个现象的主要原因，或是是否有加乘作用；她指出，研究不同的抗忧郁药物，以揭开不同药物分类、或个别药物的潜在差异是有用的。
Combination of Severe Depression and Antidepressant Use Impairs Driving Ability
Medscape Medical News
A combination of severe depression and antidepressant use may impair driving ability, new research suggests.
In a study presented here at the American Psychological Association 116th Annual Convention, researchers from the University of North Dakota found individuals with severe depression who were taking antidepressants had reduced concentration and slower reaction times behind the wheel than their counterparts with milder depression who were also taking antidepressants.
Furthermore, study participants with mild depression who were taking antidepressants performed no differently from normal controls.
"These findings suggest that together, high depression scores and antidepressant use seem to confer a double whammy, so that individuals with this combination have significantly poorer concentration and slower reaction times when driving," principal investigator Holly Dannewitz, PhD, told Medscape Psychiatry.
Conflicting Findings
According to Dr. Dannewitz, a small number of previous studies suggest some antidepressants can negatively affect individuals' cognitive performance, impairing memory and reducing reaction time. However, she added, other studies suggest antidepressant treatment has no effect on cognitive function.
To further explore the potential impact of these medications on cognitive function, and specifically driving performance, the researchers recruited 60 individuals — 31 who were on at least 1 antidepressant and 29 matched controls who were taking no medication with the exception, in some cases, of oral contraceptives.
To determine depression levels and information about current medication use, all participants completed the Beck Depression Inventory, 2nd ed (BDI-II), a History of Sadness Questionnaire, and a medical history questionnaire.
Subjects in the antidepressant group were further divided into 2 groups, 1 with average BDI-II scores of 0 – 12 and the other with above-average BDI-II scores of 14 – 39.
Study subjects participated in a computerized driving simulation to assess driving ability — specifically, steering, scanning, and concentration. Following completion of practice laps, individuals completed 4 test laps. The practice lap was the easiest and the final lap the most difficult in terms of a greater number of distracters and the need for more responses.
The driving simulator measured reaction times for 2 tasks — a peripheral and central task. The central task required subjects to hit the brake pedal in response to brake lights, while the peripheral task required participants to hit a paddle in response to a stop sign or traffic signal.
Driving Ban Not Warranted
Interestingly, said Dr. Dannewitz, there were no differences between any of the study groups in terms of their steering/tracking ability. However, the more "subtle" measures of reaction time were where individuals with high depression scores performed poorly.
Although patients with high depression scores who used antidepressant medications did worse than the other 2 study groups, Dr. Dannewitz said the impairment is not so severe that it would warrant a driving ban in such individuals.
Nevertheless, she said, physicians with patients who fit this profile should be aware that their driving ability and other functions that require optimal concentration and quick reaction time may be impaired.
Further research is warranted to tease out whether mood or medication use is the primary driver of this phenomenon or whether there may be a synergistic effect at play. It would also be useful, she said, to investigate different types of antidepressants to uncover potential differences between classes of antidepressant mediations or individual drugs.
American Psychological Association 116th Annual Convention: Abstract I-11. Presented August 17, 2008.