Comparing the effects of oxazepam and diazepam in actual highway driving and neurocognitive test performance: a validation study

S Jongen,E F P M Vuurman,J G Ramaekers,A Vermeeren

doi:10.1007/s00213-018-4844-5

S Jongen, E F P M Vuurman + Show 2 more

Open Access

https://doi.org/10.1007/s00213-018-4844-5

Copy DOI

Journal: Psychopharmacology	Publication Date: Mar 2, 2018
Citations: 10	License type: open-access

Affiliation: Maastricht University

Abstract

ObjectiveScreening of drug-induced performance impairment is needed to provide meaningful information for users and prescribers regarding the impact of drugs on driving. The main objective was to assess the effects of oxazepam 10 mg (OXA10), oxazepam 30 mg (OXA30), and diazepam 10 mg (DIA10) on standard deviation of lateral position (SDLP) in a highway driving test in actual traffic and to determine the ability of eight neurocognitive tests to detect comparable effects.MethodsTwenty-three healthy volunteers participated in a four-way double-blind, placebo-controlled, crossover study. The highway driving test was conducted between 4 and 5 h after drug intake. A range of neurocognitive tests was conducted before and after driving, 2 and 6 h post-treatment, respectively.ResultsMean SDLP increased by 1.83, 3.03, and 7.57 cm after OXA10, DIA10, and OXA30, respectively. At 2 h post-treatment, all neurocognitive tests, except the useful field of view, showed performance impairment in all active treatments. Effect sizes (ES) were moderate for OXA10, large ES for DIA10, and largest ES for OXA30. Modest correlations were found between changes in SDLP and performance in the attention network test (ANT), the divided attention test (DAT), and the psychomotor vigilance test (PVT).ConclusionOXA10 caused minor, DIA10 moderate, and OXA30 severe driving impairment. No neurocognitive test was both dose dependently sensitive and able to be associated with driving impairment. No neurocognitive test can replace the on-the-road highway driving test.

Highlights

Psychoactive drugs can have side effects, such as sedation and reduced alertness, which can cause driving impairment and increase crash risk (Dassanayake, Michie, Carter, and Jones, 2011; O’Hanlon, Haak, Blaauw, and Riemersma, 1982; Seppala, Linnoila, and Mattila, 1979)
No data were collected for this participant for the attention network test (ANT) in session 1, the driving test, and all neurocognitive tests in session 2
No data of the balance test were available for one participant in the eyes open condition in session 2 after oxazepam 10 mg (OXA10)

Summary

Introduction

Psychoactive drugs can have side effects, such as sedation and reduced alertness, which can cause driving impairment and increase crash risk (Dassanayake, Michie, Carter, and Jones, 2011; O’Hanlon, Haak, Blaauw, and Riemersma, 1982; Seppala, Linnoila, and Mattila, 1979). Drug evaluations should follow a tiered approach starting with neurocognitive tests, followed by driving simulators and on-the-road tests, as the latter generally have better validity to assess driving impairment (Berghaus and Friedel, 1999; Alvarez and del Río, 2002; Vermeeren, De Gier, and O’Hanlon, 1993; Walsh, Verstraete, Huestis, and Mørland, 2008). The standardized on-the-road highway driving test used in the Netherlands (O’Hanlon, 1984; Ramaekers, 2003; Vermeeren, 2004; Verster and Roth, 2011) is a sensitive and reliable test to assess drug-induced driving impairment. Standard deviation of lateral position (SDLP), the primary outcome measure, has been shown to be sensitive to the Psychopharmacology (2018) 235:1283–1294 effects of many sedative drugs (Leufkens and Vermeeren, 2014; O’Hanlon and Ramaekers, 1995; Ramaekers, 2003; Roth, Eklov, Drake, and Verster, 2014).

Methods

Results

Conclusion