An Exploratory Study Using the Anti-Anxiety Medication Buspirone for Driving Anxiety in Autism Spectrum Disorder

Background: The literature documents that intellectually capable autism spectrum disorder (ASD) is frequently associated with driving avoidance. Because ASD is associated with high levels of comorbid anxiety and our previous work suggested heightened anxiety during driving simulation, we evaluated whether driving behavior assessed through a driving simulator would improve with antianxiety medication. Objective: This was an open label, proof of concept, testing the usefulness and tolerability of the nonsedating, short acting anti-anxiety medication buspirone using a randomly assigned crossover design. Methods: The sample consisted of 24 adult drivers (5 female) with DSM-V ASD (mean age 28.4 years) who completed two simulated driving sessions, one while taking the anti-anxiety medication buspirone and one without it. Results: Treatment with buspirone was associated with significantly improved driving performance as measured by less variability in lane positioning, a proxy for safer driving, lower self-report anxiety scores on items involving physical sensations, and better self-report scores on the ability to concentrate while driving. Conclusions: These preliminary, proof of concept findings suggest that mitigating anxiety may improve driving performance in individuals with intellectually capable ASD, supporting the need to conduct larger controlled studies assessing this important issue.