Parkinson's disease and the ability to drive.

Criteria for assessment of the ability to drive in Germany are based on guidelines published by the Gemeinsamer Beirat für Verkehrsmedizin and incorporated into the legislation. Decisions relating to the ability to drive must always be taken on an individual basis. In parkinsonian patients the ability to drive is very often impaired by motor symptoms, psychiatric complications, multimorbidity, increased daytime sleepiness and especially by cognitive disturbances. Increased daytime tiredness is common in Parkinson's disease with additional sedative effects of all dopaminergic agents (e. g., pramipexole, ropinirole). Unwanted falling asleep (e. g., at the wheel) can be avoided if notice is taken of the early signs of tiredness. A recommendation is included how to advise patients with Parkinson's disease treated with a dopamine agonist regarding the ability to drive.