Parkinson’s disease, antiparkinson medicines, and driving

ABSTRACT

Introduction: Parkinson’s disease is a progressive neurodegenerative disorder with multiple motor and non-motor features. It is well known that the ability to drive safely is impaired in Parkinson’s disease patients. While the impairing effects on psychomotor performance and vision are well established, there is uncertainty about the increased risk of road traffic accidents among drivers with Parkinson’s disease. These issues, considering the progressive nature of Parkinson’s disease, comorbidities and the profile of unwanted effects of the pharmacological treatments used, indicate that driving automobiles is a unique concern.

Areas covered: The Driving under the Influence of Drugs, Alcohol and Medicines (DRUID) categorization and specific advice for medications used in treating Parkinson’s disease are presented.

Expert commentary: Most medicines currently in use are considered DRUID category II: Likely to produce moderate effects on fitness to drive. Health professionals treating Parkinson’s disease patients must be involved in providing proper advice and information to the patient, family and caregivers on the effects of the disorder and its medications on driving, and all possible actions should be undertaken to transition drivers with Parkinson’s disease from driving to non-driving.

KEYWORDS:

• Accidents
• traffic/prevention & control
• antiparkinson agents
• automobile driving
• cognitive impairment
• drug-related side effects and adverse reactions
• Parkinson’s disease
• Parkinson’s disease/drug therapy
• pharmaceutical preparations/classification
• risk assessment

Acknowledgments

The DRUID categorization of medicines and driving was performed in WorkPackage 4 of the DRUID project [25–27,36]: The authors would like to acknowledge all the DRUID Project WP4 Partners: Kristof Pil, Trudy van der Linden, Alain Verstraete (Ghent University– Belgium); Michel Mallaret, Charles Mercier-Guyon, Isabelle Mercier-Guyon (University of Grenoble, Centre Régional de Pharmacovigilance – France); Michael Heißing (BASt, Bundesanstalt für Straßenwesen – Germany); Katerina Touliou (CERTH-HIT, Centre for Research and Technology Hellas – Greece); Silvia Ravera, Susana P. Monteiro, Johan Jacob de Gier (University of Groningen, The Netherlands), and Trinidad Gómez-Talegón, Inmaculada Fierro (University of Valladolid –Spain).

Declaration of interest

The author has no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Additional information

Funding

This paper was not funded.