Medical histories of 61 aviation accident pilots with postmortem SSRI antidepressant residues — ( Aviation, Space, and Environmental Medicine)

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 Aviation, Space, and Environmental Medicine . 2007 Nov;78(11):1055-9.

Sen A1, Akin A, Canfield DV, Chaturvedi AK

Author information:  1Bioaeronautical Sciences Research Laboratory, Aerospace Medical Research Division, Civil Aerospace Medical Institute, Federal Aviation Administration, U.S. Department of Transportation, Oklahoma City, OK 73125-5066, USA.

Abstract

INTRODUCTION:

Selective serotonin reuptake inhibitor (SSRI) antidepressants are popularly prescribed, but these drugs are not currently approved for use by U.S. civilian aviators. In a 2003 study, the presence of 4 SSRIs–citalopram, fluoxetine, paroxetine, and sertraline-was reported in 61 pilot fatalities of civil aviation accidents that occurred during 1990-2001. However, it was not known whether these pilots had disqualifying psychological conditions, including depression, and had properly reported the use of the antidepressants.

METHODS:

The aeromedical history of the pilots was retrieved from the Federal Aviation Administration’s (FAA’s) Aerospace Medical Certification Database; additional pilot medical information and the cause/factor of the accidents were obtained from the National Transportation Safety Board’s (NTSB’s) Aviation Accident Database.

RESULTS:

There were 59 pilots who had medical records in the FAA’s Certification Database. Disqualifying psychological conditions were self-reported in the past examinations of only 7 (12%) of the 59 pilots, and the use of an SSRI was reported by 3 of the 7 pilots. In later examinations, 6 of the 7 indicated that they were free from the conditions and not taking SSRIs; thus, they were reissued medical certificates. Such conditions and/or drug use were not self-reported in the aeromedical records of the remaining 52 (88%) pilots. Nevertheless, the NTSB investigations revealed that 12 (20%) of the 61 pilots had a history of a psychological condition and/or an SSRI use, as suggested by their personal medical records.

CONCLUSIONS:

These findings reconfirm that SSRIs were used by the aviators but were not reported in their last aeromedical examinations.

PMID:
18018438
[PubMed – indexed for MEDLINE]