An explorative approach to understanding individual differences in driving performance and neurocognition in long‐term benzodiazepine users

Frederick R.J. Vinckenbosch*, Annemiek Vermeeren, Eric F.P.M. Vuurman, Nick N.J.J.M. van der Sluiszen, J.C. Verster, Aurora J A E van de Loo, Joke H van Dijken, Janet L Veldstra, Karel A Brookhuis, Dick de Waard, Johannes G. Ramaekers

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


Objective: Previous research reported cognitive and psychomotor impairments in long‐term users of benzodiazepine receptor agonists (BZRAs). This article explores the role of acute intoxication and clinical complaints.

Methods: Neurocognitive and on‐road driving performance of 19 long‐term (≥6 months) regular (≥twice weekly) BZRA users with estimated plasma concentrations, based on self‐reported use, exceeding the therapeutic threshold (CBZRA+), and 31 long‐term regular BZRA users below (CBZRA−), was compared to that of 76 controls.

Results: BZRA users performed worse on tasks of response speed, processing speed, and sustained attention. Age, but not CBZRA or self‐reported clinical complaints, was a significant covariate. Road‐tracking performance was explained by CBZRA only. The CBZRA + group exhibited increased mean standard deviation of lateral position comparable to that at blood‐alcohol concentrations of 0.5 g/L.

Conclusions: Functional impairments in long‐term BZRA users are not attributable to self‐reported clinical complaints or estimated BZRA concentrations, except for road‐tracking, which was impaired in CBZRA + users. Limitations to address are the lack of assessment of objective clinical complaints, acute task related stress, and actual BZRA plasma concentrations. In conclusion, the results confirm previous findings that demonstrate inferior performance across several psychomotor and neurocognitive domains in long‐term BZRA users.
Original languageEnglish
Article numbere2778
Pages (from-to)1-17
Number of pages17
JournalHuman Psychopharmacology-Clinical and Experimental
Issue number4
Early online date6 Feb 2021
Publication statusPublished - Jul 2021


  • benzodiazepine receptor agonists
  • benzodiazepines
  • long‐term use
  • neurocognition
  • on‐road driving
  • psychomotor functioning
  • long&#8208
  • on&#8208
  • term use
  • road driving

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