Skip to main content
padlock icon - secure page this page is secure

Selective Serotonin Reuptake Inhibitors in Pilot Fatalities of Civil Aviation Accidents, 1990-2001

Buy Article:

$27.00 + tax (Refund Policy)

Akin A, Chaturvedi AK. Selective serotonin reuptake inhibitors in pilot fatalities of civil aviation accidents, 1990-2001. Aviat Space Environ Med 2003; 74:1169–1176.

Introduction: Selective serotonin reuptake inhibitors (SSRIs) are popularly prescribed for treating depression. With a few exceptions, these psychotropic medications are not approved by aeromedical regulatory authorities for use by aviators. Since SSRIs have the potential for impairing performance and causing drug-drug interactions, the prevalence of SSRIs in pilot fatalities of civil aviation accidents was evaluated. Methods: Postmortem samples from pilots involved in fatal civil aircraft accidents are submitted to the Civil Aerospace Medical Institute (CAMI) for toxicological evaluation. Findings from such evaluations are maintained in the CAMI Toxicology Database. This database was examined for the presence of SSRIs in pilot fatalities of the accidents that occurred during 1990-2001. Results: Out of 4,184 fatal civil aviation accidents from which CAMI received samples, there were 61 accidents in which pilot fatalities had SSRIs. Of these accidents, 56 were of the general aviation category, 2 were of the air taxi and commuter category, 2 were of the agricultural category, and 1 was of the ultralight category. Blood concentrations of SSRIs in the fatalities were 11–1121 ng · ml−1 for fluoxetine; 47–13102 ng · ml−1 for sertraline; 68–1441 ng · ml−1 for paroxetine; and 314–462 ng · ml−1 for citalopram. In 39 of the 61 pilots, other drugs—for example, analgesics, antihistaminics, benzodiazepines, narcotic analgesics, and/or sympathomimetics—and/or ethanol were also present. As determined by the National Transportation Safety Board, the use of an SSRI [with or without other drug(s) and/or ethanol] has been a contributory factor in at least 9 of the 61 accidents. Conclusions: Numbers of SSRI-involved accidents were low, and blood SSRI concentrations in the associated pilot fatalities ranged from subtherapeutic to toxic levels. However, the interactive effects of other drug(s), ethanol, and/or even altitude hypoxia in producing adverse effects in the pilots cannot be ruled out. Findings from this study should be useful in investigating SSRI and other substance-involved accidents and in making decisions concerning the use of SSRIs in aviation.
No Reference information available - sign in for access.
No Citation information available - sign in for access.
No Supplementary Data.
No Article Media
No Metrics

Keywords: aviation forensic toxicology

Document Type: Research Article

Publication date: November 1, 2003

More about this publication?
  • Access Key
  • Free content
  • Partial Free content
  • New content
  • Open access content
  • Partial Open access content
  • Subscribed content
  • Partial Subscribed content
  • Free trial content
Cookie Policy
Cookie Policy
Ingenta Connect website makes use of cookies so as to keep track of data that you have filled in. I am Happy with this Find out more