Pharmacologic considerations for serotonin reuptake inhibitor use by aviators

Physicians frequently use serotonin reuptake inhibitors (SRIs) to treat a variety of psychiatric and medical conditions, many of which occur in aviators. SRIs are efficacious for treating acute conditions and may also prove useful for prophylaxis against recurrence through maintenance dosage. Aviators must meet standard safety criteria in order to use medications while performing flying duties, and must receive individual waivers as well. This article reviews the particular threats that serotonergic agents pose to aviation safety. Some SRIs may prove safer than others to use in the aviation environment, but such medications will require appropriate ground testing, and must provide aeromedically safe control of the symptoms for which they are prescribed.