Prescription of antiepileptics and the risk of road traffic crash.

Ludivine Orriols (1) , Alexandra Foubert-Samier (2) , Blandine Gadegbeku (3) , Bernard Delorme (4) , Aurore Tricotel (4) , Pierre Philip (5) , Nicholas Moore (6, 7) , Emmanuelle Lagarde (1)

1 Epidémiologie et Biostatistique [Bordeaux]
2 Equipe Epidémiologie et neuropsychologie du vieillissement cérébral,
3 UMRESTTE UMR T9405 - Unité Mixte de Recherche Epidémiologique et de Surveillance Transport Travail Environnement
4 Service de l'évaluation, de la surveillance du risque et de l'information sur le médicament
5 SANPSY - Sommeil, Addiction et Neuropsychiatrie [Bordeaux]
6 Pharmacoepidemiologie et évaluation de l'impact des produits de santé sur les populations
7 CIC - Bordeaux

Studies assessing the impact of epilepsy and its medication on the risk of road traffic crashes have shown inconsistent results. The aim in this study was to assess this risk using French databases. Data from three French national databases were extracted and matched: the national health care insurance database, police reports, and the national police database of injurious crashes. Only antiepileptics prescribed predominantly in epilepsy were studied (phenobarbital, phenytoin, ethosuximide, valproic acid, vigabatrin, tiagabin, levitiracetam, zonisamide, and lacosamide). A case-control analysis comparing responsible and non-responsible drivers and a case-crossover analysis were performed. Drivers (72 685) involved in an injurious crash in France between July 2005 and May 2008, were included. Drivers exposed to prescribed antiepileptic medicines (n = 251) had an increased risk of being responsible for a crash (OR 1.74 [1.29-2.34]). The association was also significant for the most severe epileptic patients (n = 99; OR = 2.20 [1.31-3.69]). Case-crossover analysis found no association between crash risk and treatment prescription. Patients with prescription of antiepileptic drugs should be cautioned about their potential risk of road traffic crash. This risk is however more likely to be related to seizures than to the effect of antiepileptic medicines.

Mots clés: accident de la route; épilepsie; accident; médicament

Domaines: Santé publique et épidémiologie

Ludivine Orriols, Alexandra Foubert-Samier, Blandine Gadegbeku, Bernard Delorme, Aurore Tricotel, et al.. Prescription of antiepileptics and the risk of road traffic crash.. Journal of Clinical Pharmacology, 2013, 53 (3), pp.339-44. ⟨10.1002/jcph.10⟩. ⟨hal-00937083⟩