Guidance: Psychiatric disorders: assessing fitness to drive

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Driver Vehicle Licensing Agency

January 15

11:30 2024

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?- Must not drive

! - May continue to drive subject to medical advice and/or notifying DVLA

?- May continue to drive and need not notify DVLA

Anxiety or depression mild to moderate

	Group 1 car and motorcycle	Group 2 bus and lorry
Without significant memory or concentration problems, agitation, behavioural disturbance or suicidal thoughts	?- May drive and need not notify DVLA. See Appendix E for medication considerations relevant to driving.	?- May drive and need not notify DVLA. For other cases, refer to severe below. See Appendix E for medication considerations relevant to driving.

Persistent alcohol and/or drug misuse or dependence

See Chapter 5
If psychiatric illness has been associated with substance misuse, continued misuse contraindicates driving or licensing

Severe anxiety or depression

Note: effects of severe illness are of greater importance for their relevance to driving than medication see Appendix E, for the additional considerations on medication.

	Group 1 car and motorcycle	Group 2 bus and lorry
Significant memory or concentration problems, agitation, behavioural disturbance or suicidal thoughts	?- Must not drive and must notify DVLA. Particular danger would be posed by those who may attempt suicide at the wheel. Licensing may be granted after 3 months if: ? the person has been well and stable ? the person has adhered to previously agreed treatment programmes and ? is not suffering from medicinal side effects that would affect alertness or concentration	?- Must not drive and must notify DVLA. Particular danger would be posed by those who may attempt suicide at the wheel. Licensing may be granted after 6 months if: ? the person has been well and stable ? the person has adhered to previously agreed treatment programmes and ? is not suffering from medicinal side effects that would affect alertness or concentration DVLA may need reports from a specialist in psychiatry. Driving is usually permitted after 6 months if the anxiety or depression has been long-standing but symptoms are under control and if maintenance on a dosage of psychotropic medication does not cause impairment.

Psychotic disorder including acute episode

Persistent alcohol and/or drug misuse or dependence

See Chapter 5.
If psychiatric illness has been associated with substance misuse, continued misuse, contraindicates driving or licensing.

	Group 1 car and motorcycle	Group 2 bus and lorry
	?- Must not drive during acute illness and must notify DVLA. Licensing may be considered if all of these conditions are met: ? remained well and stable for at least 3 months ? adheres to any agreed treatment plan ? free from any medication effects that would impair driving ? subject to a suitable specialist report being favourable A lack of insight which impacts upon the ability to drive safely would be a bar to licensing. Drivers with a history of instability and/or poor engagement with treatment will be required not to drive for a longer period before any relicensing.	?- Must not drive during acute illness and must notify DVLA. Licensing may be considered if all of these conditions are met: ? remained well and stable for at least 12 months ? adheres to any agreed treatment plan ? free from any medication effects that would impair driving ? subject to a favourable report from a specialist in psychiatry A lack of insight which impacts upon the ability to drive safely would be a bar to licensing. The minimum effective antipsychotic dosage should be sought, in line with good practice. Drug tolerability should be optimal and not associated with any deficits that might impair driving, such as to alertness, concentration or motor performance. Established illness with a history suggesting a likelihood of relapse: the risk of this needs to be considered low. DVLA will normally require the report of a specialist in psychiatry that specifically addresses the above issues as relevant to driving before it may grant a licence.

Hypomania or mania

Persistent alcohol and/or drug misuse or dependence

See Chapter 5.
If psychiatric illness has been associated with substance misuse, continued misuse, contraindicates driving or licensing.

For Group 2 bus and lorry driving, in both stable and unstable conditions:

the minimum effective dosage of any antipsychotic medication should be sought, in line with good practice. Drug tolerability should be optimal and not associated with any deficits that might impair driving, such as to alertness, concentration or motor performance
established illness with a history to suggest a likelihood of relapse: the risk of this must be considered low.

	Group 1 car and motorcycle	Group 2 bus and lorry
Stable There must be no driving during any acute illness.	?- Must not drive and must notify DVLA. Licensing may be considered if all of these conditions are met: ? remained well and stable for at least 3 months ? adheres to any agreed treatment plan ? free from any medication effects that would impair driving ? subject to a favourable report from a suitable specialist A lack of insight which impacts upon the ability to drive safely would be a bar to licensing.	?- Must not drive and must notify DVLA. Licensing may be considered if all of these conditions are met: ? remained well and stable for at least 12 months ? adheres to any agreed treatment plan ? free from any medication effects that would impair driving ? subject to a favourable report from a specialist in psychiatry A lack of insight which impacts upon the ability to drive safely would be a bar to licensing. See note above for both stable and unstable conditions.
Unstable 4 or more episodes of significant mood swing in the previous 12 months. Particular danger would be posed by driving if there is hypomania or mania with repeated change of mood. In all cases, there must be no driving during any acute illness.	?- Must not drive and must notify DVLA. Licensing may be considered if all of these conditions are met: ? remained well and stable for at least 6 months ? adheres to any agreed treatment plan ? free from any medication effects that would impair driving ? subject to a favourable report from a suitable specialist A lack of insight which impacts upon the ability to drive safely would be a bar to licensing.	?- Must not drive and must notify DVLA. Licensing may be considered if all of these conditions are met: ? remained well and stable for at least 12 months ? adheres to any agreed treatment plan ? free from any medication effects that would impair driving ? subject to a favourable report from a specialist in psychiatry A lack of insight which impacts upon the ability to drive safely would be a bar to licensing See note above for both stable and unstable conditions.

Schizophrenia and other chronic relapsing/remitting disorders

Persistent alcohol and/or drug misuse or dependence

See Chapter 5.
If psychiatric illness has been associated with substance misuse, continued misuse, contraindicates driving or licensing.

Group 1

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