# Review of Selected 2-Phenylethylamine Derivatives and Opioids, Systematic Review of Their Effects on Psychomotor Abilities and Driving Performance: Psychopharmacology in the Context of Road Safety

## TL;DR

This paper reviews how drugs like amphetamines and opioids affect driving skills, showing they can either improve or impair road safety depending on factors like dose and patient condition.

## Contribution

The study systematically evaluates the effects of PEA derivatives and opioids on driving performance, emphasizing dose- and condition-dependent outcomes.

## Key findings

- Therapeutic doses of amphetamine and methylphenidate improve psychomotor function in ADHD patients.
- High-dose methamphetamine and MDMA impair coordination and increase impulsivity.
- Opioids like methadone and tramadol often cause drowsiness and increased accident risk.

## Abstract

Background: Driving is a coordinated psychomotor activity that involves reaction time, attention, and decision-making. Psychoactive substances such as 2-phenylethylamine (PEA) derivatives and opioids may affect these functions and contribute to traffic safety. This systematic review revealed the effects of the selected PEA derivatives and opioids on psychomotor performance among drivers and potential road safety outcomes. Methods: The review followed PRISMA 2020 standards. Using the PICO method, we conducted a systematic search in Embase, PubMed, and Web of Science (2000–2025). Included studies involved adult participants and quantified the effect of PEA derivatives or opioids on driving-related psychomotor function. Thirty-one articles, such as randomized controlled trials, crossover studies, observational studies, and simulator-based studies, were examined. Risk of bias was evaluated using the RoB2 tool. Results: Evidence indicates therapeutic amphetamine and methylphenidate doses can enhance psychomotor function and safety in patients with ADHD. Recreational or high-dose use of methamphetamine and MDMA is associated with impaired coordination, variable speed, and increased impulsivity. Opioid effects are tolerance- and dose-dependent. Small therapeutic doses of fentanyl in chronically treated patients do not notably impair driving. On the other hand, methadone and tramadol commonly cause somnolence, retardation of reaction, and increased accident risk. Conclusions: The impact of opioids and PEA derivatives on psychomotor function is multifactorial, depending on dose, time, route of administration, and patient status. These substances can either improve or impair driving safety. The findings confirm the need for individual-specific pharmacotherapy treatment. They also highlight the importance of further studies to formulate evidence-based clinical and legislative guidelines.