Ross James, Griffiths Kathleen, Dear Keith, Emonson David, Lambeth Len
Civil Aviation Safety Authority, 36 Drevermann St., Farrer, ACT 2607, Australia.
Aviat Space Environ Med. 2007 Aug;78(8):749-55.
Australian aviation medical certification authorities began allowing use of antidepressant medications by aviation personnel in 1987; a sufficiently long period of time and number of personnel involved to allow a preliminary study. The aim of this study was to identify significant safety-related outcomes, such as aircraft accidents or incidents that may be related to the use of antidepressant medication in pilots and air traffic controllers.
The study employed a matched cohort of all holders of Australian aviation medical certificates who were prescribed antidepressants during the period 1 January 1993 to 30 June 2004 (n = 481), and a matched comparison group. Outcomes of interest were accidents and incidents.
No significant differences between the two groups were found in any of the analyses. There were 18 accidents recorded for the antidepressant group and 15 for the comparison group across the whole period, compared with 5 for cases and 5 for controls during the period while antidepressants were being taken. There were 113 incidents recorded for the antidepressant group compared with 131 controls. A non-significantly higher number of accidents and incidents were recorded among cases in the period prior to commencing antidepressant medication.
This study found no evidence of adverse safety outcomes arising from permitting individuals to operate as commercial or private aircrew or air traffic controllers while using antidepressants provided specific criteria are met and maintained. This finding has the potential to change current policies of aviation regulatory bodies internationally and may be of significance to a range of transport and other safety-critical occupations and activities.
澳大利亚航空医学认证机构于1987年开始允许航空人员使用抗抑郁药物；这一时间跨度足够长，涉及人员数量也足够多，足以开展一项初步研究。本研究的目的是确定与安全密切相关的重大结果，例如可能与飞行员和空中交通管制员使用抗抑郁药物有关的飞机事故或事件。
本研究采用了一组匹配队列，其中包括1993年1月1日至2004年6月30日期间开具了抗抑郁药物处方的所有澳大利亚航空医学证书持有者（n = 481），以及一个匹配的对照组。感兴趣的结果是事故和事件。
在任何分析中，两组之间均未发现显著差异。在整个期间，抗抑郁药物组记录了18起事故，对照组记录了15起事故，而在服用抗抑郁药物期间，病例组和对照组均为5起。抗抑郁药物组记录了113起事件，对照组为131起。在开始服用抗抑郁药物之前的时期内，病例组记录的事故和事件数量略高，但无统计学意义。
本研究发现，只要满足并维持特定标准，允许个人在使用抗抑郁药物的同时担任商业或私人机组人员或空中交通管制员，没有证据表明会产生不良安全后果。这一发现有可能改变国际航空监管机构的现行政策，可能对一系列运输及其他安全关键职业和活动具有重要意义。
