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Title: DG DISPATCH - APA: Paroxetine Safer than Mirtazapine for Car Driving Performance
URL: http://www.pslgroup.com/dg/1D25C6.htm
Doctor's Guide
May 18, 2000


By Lara Pullen
Special to DG News

CHICAGO, IL -- May 18, 2000 -- The antidepressant, paroxetine (20 mg/day), has no psychomotor or behavioral toxicity and has no negative impact on brake reaction time in a driving skills test.

In contrast, mirtazapine (15-30 mg/day), another antidepressant, significantly was shown to impair driving performance on all measures.

At the 2000 Annual Meeting of the American Psychiatric Association, Fran Ridout, MD, of the University of Surrey, England, presented the results of a double blind, balanced, four-way crossover study designed to assess the effects of paroxetine and mirtazapine on driving skills.

Twelve healthy volunteers received each medication protocol for five days. The brake reaction time (BRT) and self-assessed ratings of sedation (LARS) were administered at 14:00 on day 0 (baseline) and at 10:30 and 14:30 on days two and five.A psychometric test battery was administered at 7:00 on days 1, 2, 3, 4, and 5.

Paroxetine had no significant effect on BRT or co-administered LARS compared to placebo. Mirtazapine significantly reduced reaction time (CRT) scores compared to placebo. All treatments significantly impaired morning LARS scores relative to placebo.

Subjective ratings of sleep quality (LSEQ) were significantly improved by mirtazapine and significantly impaired by paroxetine. Thus, paroxetine seems to be suitable for use in an ambulant population. It is inadvisable, however, to use mirtazapine to treat ambulant depressed patients.

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