Road Rage and Commercial Motor Vehicle Driving: A Psychiatrist’s Perspective

A 25-year-old truck driver presents for his Medical Fitness for Duty exam. He states that he recently changed psychiatrists because he did not agree with the doctor's diagnosis of Bipolar Disorder. His new psychiatrist thinks he has Attention Deficit Disorder, and Major Depressive Disorder. He has discontinued his Bipolar Medication for mood stabilization, and is now managed on methylphenidate and fluoxetine. On further questioning, the driver candidate mentions his father, who was killed while driving a truck, had a bad temper. Although he has a history of alcohol use, currently he denies imbibing in the past three years.