Anxiety meds and SSRI's?

P

Paul S

Filing Flight Plan
Joined
Oct 31, 2012
Messages
4
Display Name
Display name:
Paul
Hi there. I thought I posted this once but don't see it, so I hope this isn't a double post.

I'm 42 and have dealt with mild social anxiety for my whole life; nothing crippling, but pretty annoying at times. It was finally diagnosed in my late 20's and I started taking some meds for it, specifically paxel and xanax. I've been off of them a couple of times since then, but life is just better on the medicine.

I decided about a year and a half ago to chase my helicopter license dream; I am currently a student pilot with only about 30 hours under my belt. I wasn't sure where it would lead me as I already own and operate a successfull engineering firm, but this is something I've wanted to do since I was a kid.

When it came time to solo I was promptly denied my medical cert for the anxiety meds. That's no surprise to most of you, I'm sure, but it was to me, considering I've be dealing with this for so long and never had any side effects with the meds (and my school never mentioned anything about this). I fully understand the FAA's position here but am looking for a way to continue the progress I've already made (and not waste the financial committment).

I asked for reconsideration and was denied, but at least they gave me some steps to take if I want to continue (I'll also note that my main instructer provided a letter to the FAA stating that in the time we had been working together he never witnessed anything that gave him concern and noted that I was a very safe pilot). But basically if my doctor agrees, go off the medicine for 90 days and give all the reports and diagnoses to them for further reconsideration. I'm at about 120 days now and about to resubmit everything.

At this point though, I'm back where I was a decade or so ago with worries and quesy stomachs and what not at various times. I see the letter the FAA released in 2010 about these SSRI's and am wondering if there is something there that I would be allowed to take.

Finally to my question (thanks for reading this far). All I see is the term SSRI's. Is there actually a medicine list that says what is encompassed by the term SSRI?

Thanks for the help! :)
Paul
 
Bruce Chien will be along later to answer your questions (he usually shows up late in the evening after work). He is a HIMS AME, specializing in difficult certifications, and on the FAA and AOPA aeromedical advisory boards. You can take what he says to the bank.
 
Dr. Chien posted a copy of the SSRI document a while back (he was one of the authors) and, as Ron says, you can take his advice on this to the bank. I'd read the document at http://www.pilotsofamerica.com/forum/showpost.php?p=790850&postcount=7 and then contact him directly through his website at http://www.aeromedicaldoc.com, though, as Ron said, he'll likely check on here in the next day or so.

Edit: From that document, you'll see that the approvable list consists of four medications:
Fluoxetine (Prozac), Sertraline (Zoloft), Citalopram (Celexa), or Escitalopram (Lexapro).
 
Last edited:
Paul S said:
I'm at about 120 days now and about to resubmit everything.
Click to expand...

Hold up on the submission until you get the straight dope from Bruce. IIRC correctly, there will be some additional documentation needed from the correct type of psychologist/psychiatrist, and not the garden variety either. Get the wrong stuff from the wrong type of doc and the quagmire gets deeper and stickier.

As the others have said, he's the right guy to help you through this minefield.
 
The, the critical item in your resubmission is a letter from you prescribing doc who needs to say the following things EXPLICITLY:

(1)took meds from __/__/___ to __/__/____. Name them and the dates.
(2)need for meds was transient, in respons to something (Name what it was).
(3)No symptoms remain
(4)No further need of Rx exists.

NOTHING SHORT OF THIS WILL DO THE JOB. If he waffles, you're done. If he talks the talk, you're going to be okay. If you've been on them a long time, they wil special issue you for a year, contingent on a followup in one year, and then if all is well, will return you to the regualr issuance pool.

Bruce
 
Last edited:
Bruce: The OP said "life is just better on the medicine." What hoops would the OP have to jump through in order to be allowed to take the meds?
 
In that case, Ron....

Well, he's got to be on one of the four meds listed in the attachment, ONE and only ONE;
.....He has to be stable on it for a whole YEAR,
.....He has to have a complimentary "P&P" (psychiatry and psychology) evaluation best from a HIMS Team (~$4,500 when all is said and done) and he has to have a HIMS AME sponsor him and see him 6 monthly. Application takes about five months. At the end of two years he needs a recap exam by the same P&P team (3rd class).

They have just simplified this for 3rd to a psychiatrist eval and a Cogscreen AE by a licensed Cogstreen AE provider, and they use that again in 2 year's time.

("...one of the four authors of the proposal....)
 
Wow, you all are awesome! Thank you so much for the excellent info. :) I wish I had known to seek out this advice when I started my lessons.

I've been so busy with work lately that this is the first chance I've had to check back, and have not re-submitted anything yet. I have talked with my doctor and Lexapro was one of the medicines that we thought was on the 'safe' list after doing some research. This is a medicine that she feels could easily substitute for the old medicine. I would prefer to try this medicine, rather than 'deal' with the anxiety.

So, if I'm reading everything correctly, I can go on the Lexapro and need to be on it for one year, safely. When that year is up I get the P&P from a HIMS team (sorry, what's that stand for?) and go to them for 6 months, then continue with an additional 5 month application process. If all goes well I get my Class III at the end of that two year period.

Is this correct and what should my next step be? Work with my phychiatrist with the Lexapro is an abovious one. Do I need to re-contact the FAA about anything at this point? Do I need to 'start' any other part of the process?

Thanks again everyone!!
 
Paul S said:
Is this correct and what should my next step be?
Click to expand...

Dr. Bruce gave you some really good general guidance there.

To do this right from the start, step up to the "pay window" and hire him privately to manage your case. The price will be reasonable when compared to other items in the aviation world, but the monster value is that his guidance will be what you need to make your initial submission as close to a sure thing as it can be.

Dr. Bruce was one of the 4 docs who wrote the SSRI protocol that's providing you the opportunity to fly. So if anyone can help you obtain your medical certificate, it's him.

Contact info for him can be found on www.aeromedicaldoc.com
 
Paul, remember you cannot be on any other psych meds beside one of these four (for the year). No Xanax, no benzodiazepine, no klonopin, etc. JUST the one med.
 
Awesome guidance all, especially Dr. Bruce. Doc, I'll be contacting you for your private guidance of my case. That sounds like money well spent. :)
 
Old Thread: Hello . There have been no replies in this thread for 365 days.
Content in this thread may no longer be relevant.
Perhaps it would be better to start a new thread instead.
Back
Top