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Scuba Diver Medical Q&A: Is it safe to scuba dive while taking antidepressants?

Approved Medical Examiner of Divers Dr Oliver Firth answers your medical questions - is it safe to scuba dive while taking antidepressant medication? What is the best exercise to keep fit as a diver? The answers are here…

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Q: There seems to be a big variation in opinion on whether it’s safe to scuba dive while taking antidepressant medication. I have a friend who is, but she is actually taking it for obsessive compulsive disorder (OCD), not depression. The drug she is on is fluoxetine (Prozac) and she has no side-effects from it. She’s been my diving buddy for several years now (and taking the Prozac all that time), and we know each other’s diving habits back to front. I feel totally safe with her so have no doubts myself, but everyone I’ve asked so far has given me a different opinion on whether it’s safe to dive on Prozac. Can you settle the question once and for all?

A: Like beer and ice cream, or sleeping tablets and laxatives, antidepressants and diving don’t tend to mix brilliantly. Again though, the devil is in the detail. It’s clear a thoroughly depressed, potentially suicidal diver on Prozac shouldn’t be getting wet, but in this case the condition we’re considering doesn’t tend to affect mood to that degree. In fact one could argue all divers would benefit from a touch of OCD. I know I do.

So applying our principles above, she has no side-effects, and has a buddy that knows her well and has dived with her for years while on medication. The SSRI’s (the class of drug to which Prozac belongs) are non-sedating and don’t impair exercise capacity. All well and good, but there is a small chance that blood thinning induced by SSRI’s could exacerbate any bleeding, should it occur. My feeling is that if she is on a low, maintenance dose and is otherwise entirely well, diving would be permissible here. But I’d always advise a proper medical in person to be sure.

Q: I’m a rather round diver in his mid-50s and I’ve decided this year to lose weight and get properly fit so I can get the most out of the diving season. Like all blokes, I’ve gone out and bought some gadgets to help me achieve this. With the current craze for fitness apps and monitors, I’ve got myself a heart rate watch and am so far reaching the target of 10,000 steps a day (it’s only been six days so far but I need all the encouragement I can get!) But given that one doesn’t do much stepping when diving, I was wondering if there are any better targets or exercises I should be doing?

A: Firstly, well done for putting your plan into action – this is often the most difficult step of the 10,000. What you’ve raised is an interesting and topical conundrum, my dear fellow. The basis of the 10,000 steps goal has recently been called into question, and it turns out that it’s just a ‘nice round number’, picked by some Japanese scientists in the run up to the Tokyo Olympics in the 1960s as a rough estimate of what an average man should do to burn 3,000 calories. Not all steps are equal, of course; for those with short legs the target of 10,000 will require far more calories to achieve than those endowed with longer lower limbs. So it’s an arbitrary ball park figure at best.

And although stepping will improve general fitness, I would argue that a diver needs to be doing something more aligned to what they will be doing in the water. One of the perennial criticisms of the Step Test used in assessing fitness for commercial divers is that it bears no relation to their underwater activities – construction, inspection, cleaning, welding, etc. For these tasks, one needs more upper body strength and dexterity. Personally, I would suggest swimming as the best all-round general exercise for you – low impact, good for the cardiovascular system, and it will develop the upper body musculature just as much as the lower. Best of luck.

Do you have a question for Dr Firth? Email divingdoctor@scubadivermag. com with your query and we will pass it on to the team at London Diving Chamber.

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Oliver Firth
Oliver Firth
Dr Oliver Firth has gained considerable experience in the field of diving and hyperbaric medicine since joining LDC in 2006. He is an Approved Medicial Examiner of Divers for the UK HSE, and a medicial referee for the UK Sport Diving Medical Committee. He is involved in the management of all types of diving-related illness, including recompression treatment, as well as providing hyperbaric oxygen therapy for non-diving conditions. He remains a passionate diver and has participated in various expeditions and conservation projects throughout the globe.

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