2010 BC Guide in Determining Fitness to Drive

29.4 Effect of psychotropic drugs on functional ability to driveOSMV is primarily concerned with the persistent cognitive impairment associated with theeffects or side effects of medication used for ongoing treatment of medical conditions. Potentialtemporary impairments from short-term treatment or changes in dosage or type of medication areconsidered transient impairments for licensing purposes.OpioidsThe use of opioids results in depression of the central nervous system. Possible effects on thefunctions necessary for driving include: blurred vision poor night vision slowed reaction times tremors impairment of short-term/working memory and attention disorientation or hallucinations sedation, and muscle rigidityThe effects of opioids on an individual depend on a number of factors, including the length ofuse, dosage, and propensity for abuse or addiction. Tolerance is an important consideration inthat adverse effects may be evident during acute use but diminish as tolerance develops.AntidepressantsThe effects of antidepressants on cognitive ability vary by therapeutic class. Depression itselfmay result in cognitive impairment. While the use of antidepressants may improve cognitivefunction, the side effects may include cognitive impairment, including: impairment of thought processing attentional deficits indecisiveness, and impairment of psychomotor function.Therefore, distinguishing between the effects of the disorder and the side-effects ofantidepressants may be a challenge.Tricyclic antidepressantsThe major side effects of TCAs that may affect driving are anticholinergic effects such asconfusion or blurred vision and sedating effects. The following table outlines the severity of thesedating effect of common TCAs.360