Automobile driving is essential for social lives in many areas, and the same is true for people with mental disorders. Both descriptions on package inserts calling for the cessation of driving and new legislation related to driving have tightened restrictions on automobile driving by people with mental disorders. However, these regulations in Japan are not based on evidence. Although epidemiological studies show that benzodiazepines are associated with traffic accidents, confounding factors make defining a causal relationship difficult. Experimental studies show that acute administrations of some drugs impair driving performance and drugs do not impair driving performance continuously and uniformly. The effect of psychotropics on driving performance is weaker in patients compared with healthy controls, and the positive effect of psychotropics on driving performance has been suggested in patients. There is no evidence that all patients with mental disorders should not drive. Psychiatrists can only provide guidance about driving consistent with the present legislation, but it is preferable to provide information based on scientific evidence and case-by-case guidance on patients' conditions. Therefore, descriptions on package inserts should be changed with reference to those of foreign countries, and discussions about legislation related to driving are needed in consideration of both patients' lives and public safety. In addition, psychiatrists should avoid giving prescriptions too easily.
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