1st class medical with anti-depressants

J

Josh Clemens

Guest
Hello,

I recently was diagnosed with IBS, and my doctor prescribed me an anti-depressants to help manage symptoms. My goal is to be able to obtain a first class medical certificate in the future, so will taking this medication for non-mental reasons hinder my chances?

Thank you
 
It's not a good idea. First off, if it is something like a tricyclic, it is never going to be certifiable. There are four SSRIs and Bupropion which can result in special issuance, but that's going to be a tough slog.
 
Josh Clemens said:
Hello,

I recently was diagnosed with IBS, and my doctor prescribed me an anti-depressants to help manage symptoms. My goal is to be able to obtain a first class medical certificate in the future, so will taking this medication for non-mental reasons hinder my chances?

Thank you
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If you haven't filled the prescription, don't. If you haven't taken the meds, take them back to the pharmacy and get proof of return from them. Get a second opinion from a doctor who understands that you can't take psychotropic drugs and easily pass an FAA medical, or pass one at all.

While it may seem like the drug is "non-mental" to you (and probably the doctor as well), I seriously doubt that the FAA will ever consider it that way.
 
dbahn said:
If you haven't filled the prescription, don't. If you haven't taken the meds, take them back to the pharmacy and get proof of return from them. Get a second opinion from a doctor who understands that you can't take psychotropic drugs and easily pass an FAA medical, or pass one at all.

While it may seem like the drug is "non-mental" to you (and probably the doctor as well), I seriously doubt that the FAA will ever consider it that way.
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Thank you for your response. So I have literally taken one pill of the ones I’ve been given, so is that too late to change? I don’t plan to be on this medicine at all anymore just because of the FAA and their requirements, but what should I do in this case? Or is there anything I can do?

Thank you
 
dbahn said:
If you haven't filled the prescription, don't. If you haven't taken the meds, take them back to the pharmacy and get proof of return from them. Get a second opinion from a doctor who understands that you can't take psychotropic drugs and easily pass an FAA medical, or pass one at all.

While it may seem like the drug is "non-mental" to you (and probably the doctor as well), I seriously doubt that the FAA will ever consider it that way.
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And after you've done this, do not, enter this drug in the list of drugs you're taking. That's for drugs you're actually taking, and if you put it down there, the FAA will take you at your word!
 
Josh Clemens said:
Thank you for your response. So I have literally taken one pill of the ones I’ve been given, so is that too late to change? I don’t plan to be on this medicine at all anymore just because of the FAA and their requirements, but what should I do in this case? Or is there anything I can do?

Thank you
Click to expand...
Too late to take the full prescription back, but take what's left back and get documentation from the pharmacist that one pill was taken and the rest returned. I would think that an AME would be able to straighten that out with the FAA. And heed Lindberg's post above as well. Telling the FAA you took one pill is like waving a red flag in front of a bull while your back is turned.

Soap box here: Doctors tend to use a careless approach to some conditions, just because it's easy. I don't know which med he prescribed, but it probably wasn't approved for treatment of IBS and is just a quick way for him to "do something that might help" instead of delving deeper into your condition. There isn't really even a clear connection of IBS and anxiety, although there's a lot of anecdotal "evidence". But even if it was approved for that condition, the FAA wouldn't care because it's still a psychotropic drug that they will assume is taken for a mental condition, which will result in thousands of dollars to prove it isn't.
 
I'd say that, as importantly, you want to confirm you haven't been diagnosed with something other than IBS, because if THAT is in your records, there is the problem. One of the medical professionals may correct me, but if you haven't taken the medication for 90 days, you don't have to disclose it. However, if you were diagnosed with anxiety, for instance, that is a problem. Just taking the meds back and not taking them anymore doesn't erase the diagnosis that you would be obligated to disclose. Just some things to consider.
 
dbahn said:
Too late to take the full prescription back, but take what's left back and get documentation from the pharmacist that one pill was taken and the rest returned. I would think that an AME would be able to straighten that out with the FAA. And heed Lindberg's post above as well. Telling the FAA you took one pill is like waving a red flag in front of a bull while your back is turned.

Soap box here: Doctors tend to use a careless approach to some conditions, just because it's easy. I don't know which med he prescribed, but it probably wasn't approved for treatment of IBS and is just a quick way for him to "do something that might help" instead of delving deeper into your condition. There isn't really even a clear connection of IBS and anxiety, although there's a lot of anecdotal "evidence". But even if it was approved for that condition, the FAA wouldn't care because it's still a psychotropic drug that they will assume is taken for a mental condition, which will result in thousands of dollars to prove it isn't.
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My understanding was that anti-depressents are used in treatment of IBS because of their side effects on the digestive system, rather than because of a link between IBS and depression/anxiety, but I could be wrong.

Nevertheless, OP, no one is suggesting you withhold information that is required to be disclosed. You must disclose the IBS diagnosis and visits to your doctor. And if the AME asks specific questions about treatments and attempted treatments, then you might have to tell him you got this prescription and took one pill. That's where the proof that you returned the remainder could be useful. But there's nothing on the form that requires you to include that information, and you would be well served to not volunteer it.
 
In addtion to what dbahn said, obtain a letter from the doc, the saying "you don't have a psychiatry diagnosis and Rx was prescribed as an adjunct to managment of IBS...."
 
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I presume the med in question is Cymbalta? There’s lots of info available about its use for IBS. Perhaps the FAA doctors should review meds based on evidence rather than prejudice?
 
Stewartb said:
I presume the med in question is Cymbalta? There’s lots of info available about its use for IBS. Perhaps the FAA doctors should review meds based on evidence rather than prejudice?
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You would think so, but just because its prescribed for IBS - doesnt mean it doesnt also affect the neuro process and doesnt have an impact there. If there is something they dont like about it because it causes some mental changes - if the patient is taking it for IBS - those other mental aspects are also affected. So the question should probably be reversed and maybe docs need to prescribe things that directly impact what they are trying to treat without impairing or impacting something else. ..
 
Anthem said:
So the question should probably be reversed and maybe docs need to prescribe things that directly impact what they are trying to treat without impairing or impacting something else. I
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I think that's already the goal of doctors, but the problem is that virtually every treatment carries a risk of "something else" which is usually undesirable and has to be weighed against the benefits. Just listen to any drug ad on TV.

The FAA basically has an opposite approach - if the side effects pose a danger to flight they are judged independently rather than against the benefits.
 
dbahn said:
I think that's already the goal of doctors, but the problem is that virtually every treatment carries a risk of "something else" which is usually undesirable and has to be weighed against the benefits. Just listen to any drug ad on TV.

The FAA basically has an opposite approach - if the side effects pose a danger to flight they are judged independently rather than against the benefits.
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Exactly. And thats the way it probably should be - if its something to do with a drug that impacts mental processes. Otherwise - saying a doc that prescribes wellbutrin because its found to work for Seborrheic Dermatitis and the person takes it - well guess what - it also has other side effects that pose a concern for people taking it - that that should be overlooked because it wasnt prescribed for /that/ issue. But guess what - it still impacts the person.
 
In this case the best advice is for the OP to speak with his physician (you know, the doctor that actually examined him) to explain the conflict of this medication with FAA regs and seek an alternative treatment. Health first, government compliance second.
 
No worries. You just have to fork over a whole bunch of money to friends of FAA aeromedical wait between 1-2 years and wahlah! You have a piece of paper that says you are fit to fly! Probably the most seamless process in the world. The folks at the faa are just fantastic at their job and are in no way a bunch of moronic leeches that are ruining aviation.
 
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