ArticleCMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne2025
Antipsychotic treatment adherence and motor vehicle crash among drivers with schizophrenia: a case-crossover study.
Article in CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Evaluating and Determining the Effects of Psychotropic Drugs on Motor Vehicle Driving Performance: Key Considerations of the Japanese Guideline and Criteria for Clinical Implementation of Evidence.Neuropsychopharmacology reports · 2026Review
- The Driving Profile of Individuals with Schizophrenia: Cognitive Characteristics, Pharmacological Treatment and Driving Competence-A Scoping Review.Neurology international · 2026Review
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Authors and funding
9 authors.
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Abstract
backgroundAmong individuals with schizophrenia, antipsychotic medications improve performance across several cognitive and functional domains. We sought to assess whether antipsychotic adherence reduces the risk of a motor vehicle crash.
methodsWe performed a case-crossover study using population-based administrative health and driving data from British Columbia, Canada. We included individuals with schizophrenia who were involved as a driver in a police-attended motor vehicle crash during a 15-year interval (2001-2016) and who filled prescriptions for antipsychotic medication as an outpatient in the 2 years before the crash. We measured adherence to antipsychotic treatment by using prescription fill data to calculate the medication possession ratio (MPR) in the 30 days before the crash (the pre-crash interval) and in a 30-day control interval ending 1 year before the crash. We used conditional logistic regression to evaluate the association between MPR and motor vehicle crash after adjusting for potential confounders.
resultsAmong 1130 eligible motor vehicle crashes involving drivers with schizophrenia, the mean antipsychotic MPR was 0.69 in the pre-crash intervals and 0.76 in the control intervals. We found that perfect adherence to antipsychotic medication was associated with half the odds of a crash relative to complete nonadherence (adjusted odds ratio 0.50, 95% confidence interval 0.38-0.66). The findings were consistent among subgroups defined by sex, age, and history of alcohol or drug misuse.
interpretationBetter adherence to antipsychotic medications was associated with lower crash risk. Physicians and fitness-to-drive policy-makers might consider antipsychotic treatment adherence as a condition for maintaining an active driver's licence among individuals with schizophrenia.
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