The effect of attention-deficit/hyperactivity disorder (ADHD) on driving behavior and risk perception.

OBJECTIVE: To examine the effect of attention-deficit/hyperactivity disorder (ADHD) on differences in driving behavior and risk perception, in experienced drivers. METHODS: A total of 147 experienced drivers participated in the study. Drivers with ADHD (n = 91) were compared to an age-matched control group of drivers (n = 56) with no neuropsychiatric diagnoses. A simulator driving test (SDT) was used in the study and included a driving scenario with various traffic environments to examine any differences in number of collisions, number of speedings, risk index (based on 12 risky situations), speed adaptation (based on 19 road sections), mean speed, and preferred speed, between the two groups. The participants also completed a questionnaire about their driving behavior. RESULTS: No differences in the simulator driving test were found between the ADHD group and the control group. No adverse effects of ADHD were found for any of the measures, i.e., collisions, number of speeding, risk index, speed adaptation, mean speed and preferred speed. The only significant group difference was that drivers with ADHD rated themselves lower on concentration. CONCLUSIONS: Participants with ADHD and the control group drove remarkably similarly in the simulator driving test and rated themselves similarly regarding how they drive. The results contribute to state that ADHD drivers are less deviant than asserted by previous research.

Ready for a Learner's Permit? Clinical Neuropsychological Off-road Tests and Driving Behaviors in a Simulator among Adolescents with ADHD and ASD.

A simulator driving test (SDT) and two neuropsychological tests, the Useful Field of View (UFOV) test and the Test of Variables of Attention (TOVA) were evaluated with regard to validity for fitness to drive on 51 young clients diagnosed with attention deficit hyperactivity disorder (ADHD), 33 of whom also had autism spectrum disorder (ASD), and 38 adolescents without a neurodevelopmental diagnosis. The results show generally much greater variability and significantly poorer performance in the SDT and the TOVA for clients with ADHD/ASD compared with the control group. The SDT results were strongly intratest correlated, but had no interest correlation with either the UFOV test or the TOVA. The greater variability among clients with ADHD/ASD suggests greater effort and susceptibility to motivational issues and decline in sustained attention over several tests. In conclusion, the SDT is sensitive and has good face validity, and the TOVA is sensitive to neuropsychological aspects of safe driving. The SDT and the TOVA thus complement each other, and discrepancy between test scores calls for special consideration.

Pressor response of oral tyramine in healthy men given amiflamine and placebo.

During two baseline challenge tests, oral tyramine (50 to 400 mg) was given to 12 healthy men to find each individual's cardiovascular pressor response. All 12 subjects "tolerated" 200 mg oral tyramine, but three of the 12 developed an increment in systolic blood pressure greater than 30 mm Hg when given a dose of 400 mg. Thereafter, amiflamine, 5 mg bid (n = 8), or placebo, 1 capsule twice a day (n = 4), were given in a double-blind fashion for 7 days, and oral tyramine challenge tests (12.5 to 400 mg) were given on days 5 to 7. During dosing with amiflamine or placebo, no subject tolerated 400 mg oral tyramine and no difference between the two regimens was found with regard to tyramine response. Plasma concentrations of amiflamine and two of its metabolites were measured on days 4 to 7. Steady-state concentrations were reached within 4 to 5 days. Plasma concentrations of tyramine after 400 mg tyramine showed a positive correlation with the increase in systolic blood pressure (P less than 0.001).

Tolerance and pilot pharmacokinetics of amiflamine after increasing single oral doses in healthy subjects.

Oral doses of 1 to 100 mg amiflamine, a new reversible monoamine oxidase type A-selective inhibitor, were given for the first time in humans to six healthy men. No apparent pharmacologic effects were recorded until the 80 mg dose. After 100 mg, one subject developed symptoms indicative of an overdose. Amiflamine is extensively metabolized by two consecutive N-demethylations. The biotransformation patterns in plasma and urine were found to correlate with the debrisoquin metabolic ratio.

[Circulatory disturbances during anaesthesia. A computer-aided analysis of 150,000 anaesthetic records 1967-1977 of the Karolinska hospital (Stockholm) (author's transl)]. / Troubles de la fonction du système circulatoire sous anesthésie. Exploitation par ordinateur de 150000 fiches d'anesthésie 1967-1977 de l'Hôpital de Karolinska de Stockholm.

The computerized anaesthetic record-keeping system at the Karolinska hospital at present (1980) contains anaesthetic records from approximately 200,000 cases. In order to evaluate the importance of circulatory disturbances during routine anaesthetic work, all records from 1967-1977 were searched for notes concerning complications. 5,996 anaesthetics were thus retrieved, having a total of 7,296 complications. This corresponds to an overall frequency of slightly more than 4 p. cent. Circulatory disturbances amounted to approximately 10 p. cent of all complications. Arrhythmias were common. Serious troubles i. e. circulatory arrests were very rare and these cases were studied individually. Differences in the frequency of complications as correlated to the preanaesthetic status of the patient including the risk group and diagnosis could be demonstrated. It is concluded that circulatory complications during anaesthesia exhibit patterns that can be analyzed from data collected during routine anaesthetic work provided a computerized anaesthetic record-keeping system is used.