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On April 6, 2010, Bob Fiddaman, author of the long-running popular website and blog, "Seroxat Sufferers," sent a request to the FAA, under the Freedom of Information Act, seeking information on the change in policy.
In the Federal Register, the FAA claims it came to its decision after "careful consideration." However, in the 58 pages of documents sent to Fiddaman on June 9, 2010 (and kindly shared with this author), there is no mention of consultations with any of the prominent SSRI experts who may have offered a contrary view. Like Peter Breggin for instance.
The FAA's response to Fiddaman shows the agency has been discussing the policy change since at least 2008. In response to a request for "minutes of meetings where the change in the policy was on the agenda," as well as a list of "members present and a declaration of interests of each of the members," the FAA sent a copy of a July 18, 2008, Memorandum, with a summary from one consultants meeting. Three outside experts attended but there were no declarations of interests, or lack thereof, by anyone at the meeting.
The summary noted that the consultants "unanimously agreed that the concept of allowing certain airmen taking antidepressant medication was reasonable and safe." But the "unanimous consensus" was that only Prozac and Zoloft "were appropriate medications due to the longevity of their use and overall safety."
"They also felt that only these two should be considered initially, and no other medications considered at this time," the summary reported.
In responding to the question of whether the new policy would apply to Air Traffic Controllers, the FAA said the "new policy does not presently apply to Air Traffic Control Specialist (ATCS) because the administrative details of the monitoring and follow-up of these employees are yet to be determined. The plan is that ATCSs will eventually be included in a program of this type."
In response to a request for any information "given to FAA from outside parties that relate to the FAA'S recent change in policy regarding pilots on antidepressant medication," the FAA sent copies of documents received from the Aerospace Medical Association, the Airline Pilots Association Aeromedical Office, the International Airline Pilots Association, and the United States Army.
"In developing the new policy, the FAA also utilized a variety of medical research literature available in the public domain," the response said. "We used internet sites such as, but not limited to: The National Library of Medicine PubMed site and the FDA Medwatch."
The documents Fiddaman received show consideration of a 2003 study of aviation accidents that found SSRIs in 61 pilot fatalities between 1990-2001, in which the psychological condition and/or the drug use was determined to be the cause, or a factor in 16 of the accidents, or 31%.
However, there was no mention of a later November 2006 study titled, "Pilot Medical History and Medications Found in Post Mortem Specimens for Aviation Accidents," led by Dennis Canfield, from the FAA's Civil Aerospace Medical Institute, in the "Aviation, Space, and Environmental Medicine" journal.
For this study, toxicological evaluations were performed on 4,143 pilots involved in fatal aviation accidents during the period between January 1, 1993, through December 31, 2003, to identify all pilots found positive for medications used to treat cardiovascular, psychological, or neurological conditions.
The evaluations found one-hundred dead pilots with SSRIs in their systems including forty with Prozac, twenty-six with Zoloft, twenty-one with Paxil, and thirteen with Celexa.
Less than a month after the new policy was announced, in "Aviation International News," on May 1, 2010, Matt Thurber reported that in a review of 127 accidents in the NTSB database since 1991, containing the word "antidepressant," only three were nonfatal.
"In 124 of those accidents, 211 people were killed," Thurber said. "In accident after accident, antidepressants ... were found in the tissues of dead pilots, and the pilots had falsified their medical certificate applications to show that they had never been treated for psychiatric problems."
Drug Free For All
No doubt in large part to Fiddaman's multi-year non-stop campaign to inform the world about the dangers of Paxil, pilots will still not be allowed to use it.
