Am I ever going to be able to get a medical?

[WannabePilot2332]

I took Wellbutrin for 6 months and Prozac for 5 years or so in middle school and high school. I didn't want to live anymore at that point in time so I told my doctor that, which is where the Wellbutrin came in. I was never actively self harming, just was down because I had been bullied. I assume taking more than one antidepressant and the suicidal ideation will permanently disqualify me.

 

[midcap]

are you taking the SSRIs right now?

there is a path way with SSRI use and the FAA only allows some, which is odd, because Drs don't even know how the meds even work, but there is a pathway.

Much easier if you have been off of them.

I think if you take them it's a bit more PITA...

 

[WannabePilot2332]

are you taking the SSRIs right now?

there is a path way with SSRI use and the FAA only allows some, which is odd, because Drs don't even know how the meds even work, but there is a pathway.

Much easier if you have been off of them.

I think if you take them it's a bit more PITA...

I'm taking a small dose of 15 mg of Prozac. It's been about 2 years since I got off of Wellbutrin.

 

[Anthem]

there are 5 that the FAA allows, but the path is far from easy. I guess its not easy being on or off of them, but the FAA has outlined the pathway. The suicide ideation I believe that Dr Chien has said on here has a 10 year minimum cooling off period before they will entertain it.

 

[WannabePilot2332]

The 10 year thing is not true.

there are 5 that the FAA allows, but the path is far from easy. I guess its not easy being on or off of them, but the FAA has outlined the pathway. The suicide ideation I believe that Dr Chien has said on here has a 10 year minimum cooling off period before they will entertain it.

"Recently, we received an inquiry asking for our policy letter regarding the 10-year wait after a suicide attempt. There is no such policy. We do not know if anyone delayed a certification request due to this, but even one unnecessary delay is too many. Please encourage your colleagues to get treatment (if needed) and seek certification. As medicine advances, we are able to certify more and more conditions."

See page 8 of the PDF.

I was NEVER HURTING MYSELF. It was teenage angst...

 

[GeorgeC]

I assume taking more than one antidepressant and the suicidal ideation will permanently disqualify me.

Not dq for life; search for dual ssri or suicidal ideation. Consider sport pilot in the interim.

 

[Auren Weinberg]

The FAA states in order to be considered for Special Issuance/ Special Consideration:

The applicant DOES NOT have symptoms or history of:

• Psychosis
• Suicidal ideation
• Electro convulsive therapy
• Treatment with multiple SSRIs concurrently
• Multi-agent drug protocol use (prior use of other psychiatric drugs in conjunction with SSRIs.)

However if you are doing well on just the Prozac, the FAA would likely consider your application. Wellbutrin is now included in the list of single medications being considered, so that is also favorable.

 

[Jon Wilder]

Not DQ, but it will be a process.

My advice would be to consult with a HIMS AME for further assistance. Make a "consult only" appointment with a HIMS AME. DO NOT fill out a MedXpress application at this point!!!

Paging @bbchien

 

[WannabePilot2332]

The FAA states in order to be considered for Special Issuance/ Special Consideration:

The applicant DOES NOT have symptoms or history of:

• Psychosis
• Suicidal ideation
• Electro convulsive therapy
• Treatment with multiple SSRIs concurrently
• Multi-agent drug protocol use (prior use of other psychiatric drugs in conjunction with SSRIs.)

However if you are doing well on just the Prozac, the FAA would likely consider your application. Wellbutrin is now included in the list of single medications being considered, so that is also favorable.

The antidepressants were concurrent, so I guess I'm SOL.

 

[bbchien]

There is no published 10 year “reconsideration of diagnosis” but that IS how it works. No meds, no events, and a well documented interim “successful life test”…is a huge hint that the initial diagnosis just MIGHT be incorrect!

 

[Jon Wilder]

The antidepressants were concurrent, so I guess I'm SOL.

I wouldn't say SOL. Just because you DID take concurrent psych meds doesn't mean you're done and that's it.

What's important is where you are now. You're taking Prozac, which is working for you. This is a FAA approved medication for single use applications. You fall within this.

You will more than likely require a HIMS psychiatric evaluation and a neuropsych test. Both of these are expensive.

You will more than likely end up in the HIMS program if they issue you.

Yes it is a very long and arduous process, but not impossible.

 

[Kenny Phillips]

I wouldn't say SOL. Just because you DID take concurrent psych meds doesn't mean you're done and that's it.

What's important is where you are now. You're taking Prozac, which is working for you. This is a FAA approved medication for single use applications. You fall within this.

You will more than likely require a HIMS psychiatric evaluation and a neuropsych test. Both of these are expensive.

You will more than likely end up in the HIMS program if they issue you.

Yes it is a very long and arduous process, but not impossible.

Fly Sport Pilot, and be aware that the allowed aircraft is quite likely to increase greatly with the MOSAIC implementation.
That may cover your needs for the future, or, at the least, let you get a decade of experience in "regular" airplanes.

 

[bbchien]

I wouldn't say SOL. Just because you DID take concurrent psych meds doesn't mean you're done and that's it.

What's important is where you are now. You're taking Prozac, which is working for you. This is a FAA approved medication for single use applications. You fall within this.

You will more than likely require a HIMS psychiatric evaluation and a neuropsych test. Both of these are expensive.

You will more than likely end up in the HIMS program if they issue you.

Yes it is a very long and arduous process, but not impossible.

Jon, IME (and it's with a good many HIMS psychiatrists), the HIMS psychiatrists as a group will not recommend consideration of a post suicidal situation until the after ten years of No meds, no events and a well documented successful life test. That's just how it is. Whether or not the FAS has issued or never issued something in writing is pretty immaterial. I have experienced how this works.

The real question is if the OP can go with Decision path 1. Throwing your meds away without the doc's assent or managment is frequently a DANGEROUS thing to do. .

 

[Extra Cautious]

Jon, IME (and it's with a good many HIMS psychiatrists), the HIMS psychiatrists as a group will not recommend consideration of a post suicidal situation until the after ten years of No meds, no events and a well documented successful life test. That's just how it is. Whether or not the FAS has issued or never issued something in writing is pretty immaterial. I have experienced how this works.

The real question is if the OP can go with Decision path 1. Throwing your meds away without the doc's assent or managment is frequently a DANGEROUS thing to do. .

Dr. Chien, what would a person need to include in a "well documented successful life test"?

If it has been more than 15 years since a person has had any suicidal ideation, clinical depression, nor has taken any SSRI, since that time.

And documentation that a person has ever taken any SSRI medication, either no longer exists or is accessible by the general public.

Would that person be eligible for SSRI pathway 1, or would that person have to start taking a FAA allowed SSRI for 6 months and proceed thru SSRI pathway 2?

 

[Jon Wilder]

Jon, IME (and it's with a good many HIMS psychiatrists), the HIMS psychiatrists as a group will not recommend consideration of a post suicidal situation until the after ten years of No meds, no events and a well documented successful life test. That's just how it is. Whether or not the FAS has issued or never issued something in writing is pretty immaterial. I have experienced how this works.

The real question is if the OP can go with Decision path 1. Throwing your meds away without the doc's assent or managment is frequently a DANGEROUS thing to do. .

So this sounds more like internal policy amongst HIMS psychiatrists than it does any sort of FAA written policy.

 

[Palmpilot]

So this sounds more like internal policy amongst HIMS psychiatrists than it does any sort of FAA written policy.

14 CFR 67.307(c) leaves a lot to the judgment of the Federal Air Surgeon (who I assume delegates that judgment to the people he or she has designated).

 

[WingmanMed]

The 10-year wait after suicidal ideation was historically true from my understanding, but the FAA has been softening its stance. They really do consider each application on a case by case basis. That's good in the sense that pilots who have struggled and recovered get to have the unique circumstances consider, but it's also a significant cause of the huge backlog of behavioral health-related applications. No two suicidal ideations are exactly the same.

The incomplete list of documents you'll need includes all treatment records related to your mental health treatment, current notes from the healthcare providers you're working with now, a HIMS neuropsychological assessment (if you continue SSRIs), and a board certified (preferably HIMS) psychiatrist assessment. A HIMS psychiatrist is required if still taking an antidepressant.

As far as choosing SSRI pathway 1 or 2, my recommendation is always to focus on optimizing your health first and FAA medical certification second. You can get a medical certificate whether taking an approved antidepressant or not. It will take a long time either way, but maintaining you medical certification (and functioning in life) will be much easier if you choose your treatment based staying healthy rather than conforming what you think will be administratively expedient with the FAA.

 

[bbchien]

The ten year rule comes from DSM 4, as I understand it. Remember FAA does not use DSM5. And I agree, do not make a life choice based on a bureaucratic requirement.