Patients with diabetes who have not had a sudden event affecting consciousness for 3 years can continue to drive. Antihistamines may produce sedative effects, including somnolence and slower reaction times. Benzodiazepines, which are among the most frequently prescribed drugs for the elderly, should never be taken before or during driving. Many benzodiazepines have extremely long half-lives and can cause motor dysfunction, visual impairment, cognitive decline, and decreased attention, especially in the elderly. Taking modest doses of frequently used benzodiazepines impairs driving performance in the elderly driver to a level similar to the legal definition of alcohol intoxication.
Similar concerns are relevant when antidepressants are prescribed.
Single doses of amitriptyline, imipramine, and doxepin, which have sedative effects, can impair many functions involved in driving. Other drugs with sedative effects, including opioid analgesics and antihistamines, may also affect driving performance. Use of alcohol, alone or in combination with other drugs, can have tragic consequences for any driver, regardless of age. In general, the elderly consume alcohol less frequently than any other age group and are involved in fewer alcohol-related fatal crashes. However, elderly drivers should be counseled against alcohol consumption before driving.