If you think that it is irresponsible prescribing, your recourse should be to go after the prescriber's license to practice medicine and not your friend's driver's license.

The consequences of losing a license are catastrophic in places where public transit is subpar.

I lost the license in 2009 because my then husband first decided that he would be driving me himself after my suicide attempt, then changed his mind due to our internal dynamics, and then told my GP that he would not be driving me (nobody asked him to drive me or to talk to my GP).

All the while, I was driving just fine on 900 mg of Seroquel (almost as much as your friend takes), without any issues (I have never had any issues with driving, on meds or off meds).

The GP, a young woman, was trigger-happy and reported me to the DMV. I later shamed her for that and she quickly filled out an MD evaluation form and sent it to the DMV, saying that I was OK.

Well, they believed her for the purposes of revoking my license but not for the purposes of giving me my license back - for that, they needed the form filled out by a p-doc. Eventually I recovered the license and I have a perfect driving record with no points.

A couple of take-aways for you:

- one can drive fine on 1000 mg Seroquel, because her reaction to taking 1000 mg Seroquel and my reaction to taking 900 mg Seroquel are independent of your reaction to taking 50 mg Seroquel, as noted above by amandalouise and Perna.

- you would not be able to undo the damage if you report and the agency listens to you.

Nor is her recall of the conversations between the two of you related to her driving skills, as noted above by Perna.

And her self-reported clumsiness has very little to do with her driving ability, because she is driving a car and not riding a unicycle, and you do not need to be an acrobat to drive a car. Clumsiness has to be really severe to stop one from driving a car, especially an automatic transmission.

Now, you are in Ontario, right? You are not in Copenhagen and not in Amsterdam, so you should realize that public transit would be lacking for your friend if you report her. And you do realize it - you said that " I know she'd be devastated to lose her license".

So you are making wild errors in judgment by believing that her reaction to her medications matches your reaction to same medications, by believing that one needs to be super nimble to drive a car, etc., and with those wild errors in judgment you want to do something that would devastate your friend? Are you in your sound mind?

You are of course entitled to believing what you believe, but the proper course of action for you in that case is to find out who her prescriber is and to write him or her a letter.

I do agree with you that 1000 mg of Seroquel is a very high dose, and "20 mg of clonazapam (Klonopin) daily" is a HUGE dose, but still it does not justify you in taking a step that could very well lead to devastating consequences.

Unless, of course, you can first agree to drive your friend anywhere she needs to be driven 24/7 on a 30-min notice for her lifetime. Are you willing and able to do that? And if you are able and willing to do that, have you thought of what would happen if she were to survive you upon your death?

More on undoing the damage. You would not be able to reverse the impact of your report. If you change your mind, if you come to the realization that her reaction to 1000 mg of Seroquel is independent of your reaction to 50 mg of Seroquel AFTER you have reported her, you would not be able to undo the damage. If you find yourself in this dilemma in which you are tempted to do damage that you would not have power to undo, you really should take more peaceful steps first. You say that she has two doctors who are both lax and that she confides in you. If she confides in you, obtaining the names of her doctors should not be difficult for you. Once you have their names, you will be able to write to them or to write to the licensing boards complaining about them, saying that they are irresponsible. I do not know if the licensing boards in Ontario consider complaints from non-patient third parties, but it would be worth looking into. After all, it would make sense of them to consider such complaints, since your caring about the prescribing standards of the licensees is in the public interest...