Association of benzodiazepines, Z-drugs, pregabalin, and melatonin with traffic accidents: A nationwide cohort and case-crossover study in Danish adults
Research output: Contribution to journal › Journal article › Research › peer-review
BACKGROUND: Benzodiazepines, Z-drugs, pregabalin, and melatonin (BZPMs) have been associated with a higher risk of traffic accidents, but the evidence is inconsistent, and lacking for newer drugs.
AIM: To examine the association of BZPMs with risk of traffic accidents.
METHODS: All Danish adults (n = 3,823,588) were followed for redeemed prescriptions of BZPM and for incident traffic accidents registered in Danish registers from 2002 through 2018. Associations were examined in cohort and case-crossover designs using Cox proportional hazard and conditional logistic regression with adjustment for co-variables.
RESULTS: A total of 19.3% (n = 738,019) of all participants initiated treatment with BZPMs. During the mean follow-up of 10.3 years, 595,173(15.5%) of participants were involved in a traffic accident. In the cohort analysis, all BZPMs besides pregabalin were associated with a higher risk of traffic accidents in adults below 70 years, with chlordiazepoxide showing the strongest association (hazard ratio (HR)age 18-49 = 1.76, 95% confidence interval (CI): 1.67-1.86 and HRage 50-69 = 1.84, 95% CI: 1.70-2.00). In the older age groups, the specific BZPM medications were associated with lower or no risk of traffic accidents. However, in case-time-crossover analysis with inherited control for confounders, no BZPM medication was positively associated with traffic accidents, except for chlordiazepoxide, which had a higher odds ratio in middle-aged group (1.62, 95% CI: 1.15-2.29).
CONCLUSIONS: This study does not fully support that BZPM use is a risk factor for traffic accidents. However, a positive association was found for chlordiazepoxide, which is approved for treatment of acute alcohol withdrawal.
Original language | English |
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Journal | Journal of psychopharmacology (Oxford, England) |
Volume | 36 |
Issue number | 4 |
Pages (from-to) | 470-478 |
Number of pages | 9 |
ISSN | 0269-8811 |
DOIs | |
Publication status | Published - 2022 |
- Accidents, Traffic, Adolescent, Adult, Aged, Alcoholism, Benzodiazepines/adverse effects, Chlordiazepoxide, Cohort Studies, Cross-Over Studies, Denmark/epidemiology, Humans, Melatonin/adverse effects, Middle Aged, Pregabalin/adverse effects, Substance Withdrawal Syndrome, Young Adult
Research areas
ID: 305518223