(150) Association of Benzodiazepines, Z-Drugs, Pregabalin and Melatonin with Traffic Accidents

Publication Number: 481

Background: Benzodiazepines and benzodiazepine related drugs (BZRD) have cognitive side effects in many patients and consequently their influence on the risk of traffic accidents have been questioned

Objectives: To examine the association of benzodiazepines, Z-drugs, pregabaline and melatonin (BZPM) 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.

Results: A total of 19.3%(n=738019) of all participants initiated treatment with BZPMs. During the mean follow-up of 10.3 years, 595173(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 chlordiapoxide showing the strongest association(HRage 18-49=1.76,95%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 chlordiapoxide, which had a higher odds ratio in middle-aged(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 chlordiapoxide, which is approved for treatment of acute alcohol withdrawal.