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Psychopharmacology in Aviation
Published in Carrie H. Kennedy, Gary G. Kay, Aeromedical Psychology, 2013
Bradford C. Ashley, Gary G. Kay
Historically MDD has been managed with a combination of psychotherapy and medication. The first medications developed were those based upon the monoamine hypothesis of depression. These early medications include monoamine oxidase inhibitors (MAOIs) and tricyclic antidepressants (TCAs). These are effective treatments for MDD, however, their side-effects render them unsuitable as maintenance therapy for depressed aviators. In the past, pilots would be diagnosed with depression, prescribed one of these medications, and treated for a fixed period of time. Once it was determined that the MDD episode was in full remission, the medication was discontinued, and then, after several months the pilot was eventually re-evaluated and if found to be free of depression was issued a medical certificate. This process often took years. During this time the pilot was not able to perform their occupation or enjoy general aviation flying. As a result, pilots often flew while depressed, self-medicated with non-efficacious “remedies,” received surreptitious treatment (off the books), and failed to disclose their condition to their AME since the diagnosis of MDD could potentially ruin their flying careers.
Centella asiatica L. Urban protects against morphological aberrations induced by chronic unpredictable mild stress in rat’s hippocampus via attenuation of oxidative stress
Published in Egyptian Journal of Basic and Applied Sciences, 2022
Saravanan Jagadeesan, Samaila Musa Chiroma, Mohamad Aris Mohd Moklas, Mohamad Taufik Hidayat Baharuldin, Che Norma Mat Taib, Zulkhairi Amom, Thirupathirao Vishnumukkala, Warren Thomas, Onesimus Mahdi
The current drug treatment for depression is based on selective serotonin reuptake inhibitors (SSRI’s), monoamine oxidase inhibitors (MAOI’s), and tricyclic antidepressants (TCA’s). These treatments have significantly contributed to enhancing the quality of life of individuals with depression, but they are not without their limitations. The current medications do not produce a uniform response among patients, it takes weeks for their effects to be observed and many treatments have significant side effects [16]. The concurrent use of multiple drugs complicates the problems through complex interactions and in particular gives rise to uncertainty regarding their safe use in pregnancy [17]. Fluoxetine is a commonly used antidepressant, and as an SSRI, it inhibits the serotonin transporters at the synaptic cleft. Though in wide use, fluoxetine has side effects including fatigue, weight gain, and sexual dysfunction [18,19]. Thus, though there is a wide range of medications available for the treatment of depression, none of them are universally effective or without side effects. Consequently, there is a need for new therapeutic agents with lesser side effects and broader efficacy [20]. In order to achieve this, it is necessary to consider the critical physiological processes that contribute to stress and depression.