Anticholinergic Versus Antihistaminic Treatment for Simulator Sickness Prevention.

Flight simulators have an essential role in aircrew training. Occasionally, symptoms of motion sickness, defined as simulator sickness, develop during these sessions. Preventive methods for motion sickness have been investigated thoroughly; however, only a few studies have examined preventive treatments for simulator sickness. The aim of this study was to examine the efficacy of scopolamine (an anticholinergic drug) compared with cinnarizine (an antihistaminic drug) for helicopter simulator sickness prevention. A validated simulator sickness questionnaire (SSQ) score was used to determine the severity of simulator sickness symptoms in this study. Preliminary SSQ scores and SSQ scores after each sortie were calculated. Each participant was given scopolamine, cinnarizine, or a placebo in a double-blind randomized manner before the first sortie of each training day. Forty-one helicopter pilots participated in the trial. The average age was 30.5 ± 7.1 years. SSQ values significantly improved from an average of 73.30 in the preliminary SSQ questionnaire to an average of 30.92 after 2 hours following the administration of cinnarizine (P = .012, 95%CI 8.071-76.703). Scopolamine was found to be less effective than both cinnarizine and the placebo in the alleviation of simulator sickness symptoms. This study is the first to compare scopolamine with cinnarizine for simulator sickness prevention. Based on the results of this study, we recommend the use of cinnarizine over scopolamine for simulator sickness prevention.

Success Rates at an Air Force Pilot Academy and Its Relation to Methylphenidate Use.

BACKGROUND: Attention deficit hyperactivity disorder (ADHD) is a chronic neurological disorder characterized by persistent patterns of inattention, impulsivity, and hyperactivity. The most common treatment for this disorder is methylphenidate, which is a disqualifying medication for flight. Candidates with previous use of methylphenidate are not necessarily disqualified from the Israeli Air Force (IAF) flight academy.METHODS: Flight cadets from 12 consecutive flight courses who have used methylphenidate at least once in the past were identified according to their medical records. The graduation ratio of cadets with previous use of methylphenidate was compared with that of the rest of the cadets. A comparison was also made with regard to the causes of disqualification from the flight course. Statistical significance was assessed using the Fischer Test.RESULTS: Among the 90 flight cadets who have used methylphenidate, only 2 (2.2%) successfully graduated from the IAF flight academy. Among the 2983 flight cadets who have no history of methylphenidate use, 461 (15.4%) successfully graduated. We found no significant differences in the disqualification causes between the two groups.CONCLUSION: The IAF flight academy graduation rate was meaningfully and significantly lower among cadets who reported previous use of methylphenidate. The study design, however, limits the inference of causal relationship.Sarfati S, Nakdimon I, Tsodyks J, Assa A, Gordon B. Success rates at an air force pilot academy and its relation to methylphenidate use. Aerosp Med Hum Perform. 2019; 90(9):788-791.