Considerations of pharmacology on fitness for duty in the operational environment.

Coordination of strategies for transitioning psychoactive pharmacological compounds from basic laboratory research to the field environment has been an ongoing effort among military laboratories. Several workshops have been held specifically to address the operationally relevant issues and other military and scientific challenges as they relate to the enhancement and sustainability of cognitive performance. In this preface, we tie together recommendations of the Pharmacological Strategies Focus Team for one such Workshop, review current literature, and discuss findings reported at recent professional meetings. The papers presented within this pharmacology section are discussed. These section papers are organized into three areas of operational relevance--the first assesses the effectiveness of a treatment given for migraines, a condition with known detrimental effects on productivity and readiness; the second discusses ethical considerations surrounding the use of pharmaceutical countermeasures for fatigue in the operational environment; and the third discusses a case report highlighting the aeromedical considerations regarding selective serotonin reuptake inhibitors (SSRIs) and aviator flight performance, particularly as assessed with neuropsychological testing. The papers and commentaries in this section encourage us to consider the complex variables effecting the decisions to administer pharmacological agents, as the impact of their use is weighed against the cognitive performance effects they may have in the operational environment.