Monday, April 26, 2010

It depresses me to think that pilots are flying while taking anti-depressant medications

I am concerned about the new ruling that lets pilots fly while taking anti-depressant medication. I do not believe it is a good idea. As both a pilot and a physician, I think there are real risk potentials to flying under the influence of these pharmaceuticals.

A review of the antidepressants literature is worth summarizing here. I am including information from an article in Helpguide* subtitled “When it comes to depression, serotonin doesn’t tell the whole story.” Serotonin is a chemical that is normally found within the brain. Apparently there are many factors that play a role in depression. Serotonin, however, may only be a bit player. Therefore drugs that promote levels of serotonin in the brain, may or may not positively affect depression. I bring this up because all the drugs recently approved by the FAA: Prozac, Zoloft, Celexa, and Lexapro are all part of the class of serotonin reuptake inhibitors or SSRI’s.

More importantly, these meds like almost all meds, may have side effects. Specifically these class of drugs (SSRI’s) may have the following side effects (SE’s):
Decreased sex drive
Weight gain or loss
Dry mouth
Although the article in Helpguide stated the above side effects as common, no actual incidence data was given. An additional warning was that there may be serious withdrawl effects if the drug is stopped too rapidly.

In the above list of possible SE’s, there are several that would be particularly bad for a pilot e.g: dizziness, anxiety, tremors, nausea and sleeepiness. Would you like to be a passenger flown by a pilot who may have some or all of these SE’s? No, I don’t think so. Or imagine a pilot executing an ILS approach in low IFR conditions, who suddenly becomes apprehensive or dizzy or even nauseas for example. Those “side effects” could lead to disaster.

I have read the argument that millions of drivers take untold millions of medications, some with deleterious effects on their driving skills. But at least someone driving with a sudden bad reaction can pull over to the curb. Yes if one is lucky. I had an example of a bad reaction to a "safe" drug while undergoing treatment for routine enlargemant of the prostate. While returning from the restroom at a local reataurant, I suddenly felt light headed and passed out cold. This was a known possible side effect of that medication. Luckily I wasn't driving or worse flying a plane! Without a co-pilot to bail one out, no pilot should be taking any medication unless they are totally familiar with it and its possible side effects.
So, I challenge the FAA medical experts to counter some of these concerns of mine. In the mean time. Don’t take any medications until you know without a doubt how it affects you.

* 4/16/2010