Abstract
Acute benzodiazepine intoxication produces severe impairment of neurocognitive skills
related to driving. It is less clear whether such impairments also occur in patients
who use benzodiazepines chronically. The current review evaluated neurocognitive skills
of long-term benzodiazepine users and addressed 2 major questions: do long-term users
develop tolerance for the impairing effects of benzodiazepines on neurocognitive performance,
and if so, does tolerance warrant a change in driver fitness classification systems
that currently deem users of benzodiazepines unfit to drive? Neurocognitive impairments
were reported in patients who on average used benzodiazepines for 5–15 years. In addition,
sensitivity to acute benzodiazepine impairment decreased in long-term users, suggesting
(partial) tolerance. Definitions of clinical relevance of neurocognitive impairments
in long-term users and how these were affected by duration of benzodiazepine use were
generally lacking. Also, sensitivity of neurocognitive tasks to drug effects and their
validity to predict fitness to drive were generally unknown. Because of these limitations,
no firm conclusion can be drawn regarding a re-classification of long-term benzodiazepine
effects on driver fitness.
Key words
benzodiazepines - fitness to drive - long-term use
