Antidepressant usage and civilian aviation activity in Australia 1993-2004

Since at least 1993 Australia, through the Civil Aviation Safety Authority, has
been allowing a large number of both commercial and private pilots, and Air Traffic Controllers (ATCs) to continue to be medically certified for aviation activities despite being on antidepressant medication. This is at variance to the generally accepted approach in other comparable jurisdictions. In order to evaluate whether the policy of certifying aircrew and ATCs based on meeting set criteria while using antidepressants was safe, a retrospective case-control study was undertaken, utilising data collected by CASA from 1993 to 2004 for cases where the applicant requires assessment as to whether they meet the standard for certification, and data for aviation accidents and incidents collected by the Australian Transport Safety Bureau for the same period. The primary aim was to assess the safety of the use of antidepressant medication, in subjects where there was a clinical justification for the prescription, against controls who did not use antidepressant medication, rather than the underlying medical condition.