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New sedative users have increased risk for car wrecks

Patients who recently initiated use of sedative hypnotics are at an increased risk of being involved in a motor vehicle accident, with risks being comparable to individuals who drive while intoxicated, according to recently published data.  

“This study suggests that filled prescriptions for [three] different types of sedative hypnotic agents were associated with increased risk of motor vehicle crash for new users of these medications. Sedative hypnotic exposure nearly doubled the risk of crash in new users,” researchers wrote. 

Researchers conducted a retrospective population study of 409,171 adults, aged 21 years and older, in the Group Health Cooperative in Washington State to assess the association between sedative hypnotic use and risk of motor vehicle accident.

Among those prescribed a sedative (n = 23,803), 56% were prescribed trazodone, 22% were prescribed temazepam and 22% were prescribed zolpidem.

Results demonstrated that an increased risk of car accidents was associated with all three sedatives (HR = 1.90; 95% CI, 1.63–2.20). Patients who were new to sedative use were at an increased risk of car accidents, compared with those who did not use sedatives; temazepam (HR = 1.27; 95% CI, 0.85–1.91), trazodone (HR = 1.91; 95% CI, 1.6–2.25) and zolpidem (HR = 2.20; 95% CI, 1.64–2.95).

The highest rates of motor vehicle accidents occurred between 121 and 240 days after sedative initiation (HR = 4.41; 95% CI, 2.96–5.78), but the researchers noted that trazodone was the primary sedative responsible for crashes during that time period (HR = 4.20; 95% CI, 2.91–6.05). For zolpidem users, the highest risk of crash occurred between 31 and 120 days after exposure (HR = 5.69; 95% CI, 3.14–10.29).

While the risk of crash decreased over time for all three medications, which the researchers said could be due to increased medication tolerance or driving adjustments due to medication risks, there was still an increased risk of motor vehicle accidents compared with those who did not use hypnotic sedatives.

The researchers noted that for future studies, it will be important to assess any underlying sleep disorders patients may have, in order to identify whether medications or disorders are increasing the risk of car accidents.

“In the interest of the public safety of the roads and highways in the United States, individuals who have been prescribed sedative hypnotic medications should be counseled about driving risk and alternative transportation strategies addressed when under the influence of these medications,” the researchers concluded. – by Casey Hower

Disclosure: The researchers report no relevant financial disclosures.