Ever received a medical after past history of Abilify?

[Tom Simmons]

Long story short I had an extended moment of anxiety/OCd in my life and went to my doctor regarding it. I went through a few medications such as Xanax, Klonopin and eventually Abilify before I went to a psychiatrist and was prescribed Lexapro and Buspirone (to reduce side effects from Lexapro). I was on Lexapro for about a year before getting off. I was prescribed abilify xanax and klonopin for maybe a month before I started on the Lexapro and Buspirone.

My question is does the prescription of Abilify immediately throw my SI in the trash can since it’s an antipsychotic? If not, I’m assuming the numerous psych meds in a very short period may immediately end in a denial. This is for a 3rd class medical btw.

 

[redbaron]

Because you were on a multi-agent protocol, SSRI path 1 is no longer an option for you unless this 'extended moment' was far in the past (10+ years). The FAA's view is that whatever 'it' was, you had it, you had markers of severity (multi-agent protocol), and you still have it. So why would they let you fly unmedicated? Regardless of the flaws in the logic that is the official policy stance of a federal agency of the executive branch.

Your only way forward would be on decision path 2, of which there are also other rule outs and you will need a HIMS AME on your side to guide you through. This site won't let me post links but here is an old post where Dr. Bruce @bbchien references some of the pitfalls and resources required for path 2: pic {DOT} aopa {DOT} org/discuss/viewtopic/168/1879

 

[TCABM]

Sport Pilot does not require a medical.

 

[SkyChaser]

Most likely, getting a medical with that history will be next to impossible. However, if you're just flying for fun, you really should look into Sport Pilot. You have to fly Day VFR, can only fly certain, smaller planes, and have some other limitations, but it is a very valid and viable option that doesn't require going through the FAA Aeromedical division.

 

[Clip4]

Most likely, getting a medical with that history will be next to impossible. However, if you're just flying for fun, you really should look into Sport Pilot. You have to fly Day VFR, can only fly certain, smaller planes, and have some other limitations, but it is a very valid and viable option that doesn't require going through the FAA Aeromedical division.

Or maybe he really shouldn’t.

 

[WingmanMed]

There are very few differences between the medical requirements for a 3rd class, 2nd class or 1st class. Primarily it comes down to how often the FAA wants you evaluated. There are some things specified with cardiology as well, but the rest is all subjective within the FAA halls. You can fly any aircraft with a 3rd class medical - there are no limitations.

This will be very difficult to get a medical. Not necessarily impossible, but very difficult. You will need to work with a very good AME and you will need to have a well documented history of recovery and stabilization. This will most likely cost you a lot of money and take well over a year.

 

[bbchien]

Because you were on a multi-agent protocol, SSRI path 1 is no longer an option for you unless this 'extended moment' was far in the past (10+ years). The FAA's view is that whatever 'it' was, you had it, you had markers of severity (multi-agent protocol), and you still have it. So why would they let you fly unmedicated? Regardless of the flaws in the logic that is the official policy stance of a federal agency of the executive branch.

mostly right but I think the terms may be reversed. Dual meds at once means no application ON SSRI, as dual meds is a severity indicator, as is suicidality. (="Path 2")

For application discontinued ("Path 1") you must have no history of suicidailty, duration <5 years and no prior episode, for that is part of the definition of "recurrent disease". 100% of recurrent disease untreated and unmonitored" gets denied.

 

[Anthem]

There are very few differences between the medical requirements for a 3rd class, 2nd class or 1st class. Primarily it comes down to how often the FAA wants you evaluated. There are some things specified with cardiology as well, but the rest is all subjective within the FAA halls.

You missed one aspect between 2nd and 3rd. . primarily vision must be correctable to 20/20 instead of 20/40 for 3rd

 

[Andy Bader]

mostly right but I think the terms may be reversed. Dual meds at once means no application ON SSRI, as dual meds is a severity indicator, as is suicidality. (="Path 2")

For application discontinued ("Path 1") you must have no history of suicidailty, duration <5 years and no prior episode, for that is part of the definition of "recurrent disease". 100% of recurrent disease untreated and unmonitored" gets denied.

Dr. Chien, can you offer any more guidance about the dual meds? I have been steady on 40mg citalopram for two and a half years. I am 22 months into the HIMS AME submission process with my case currently in DC, scheduled to be out in October.

My wife and I had a stressful time in our lives back in January 2021 (brand new baby and we had to sell her family business). She was having a really rough time and got a prescription for Xanax as needed from our GP. I got one as well, thinking, "well, maybe this will help me relax. Why not?" GP said sure. I tried it three times and it didn't do anything for me so I discontinued immediately.

My HIMS AME is not concerned about this, specifically due to the short duration. He said "If someone is currently on more than one drug for depression, anxiety, they will not be considered. If in the past, they had trials of other non-approved drugs or had been on more than one drug, but now they are on a single acceptable medication, they will be considered." This is not my reading of the SSRI guidelines at all, but he should know better than I would. But your description of it as a marker of severity makes sense and has me very concerned.

Is this generally an immediate denial by DC or do they exercise any judgment here? (Is it at all promising that it made it out of OKC after a year and a half or would it do that before a denial from DC regardless?)

 

[bbchien]

Dr. Chien, can you offer any more guidance about the dual meds? I have been steady on 40mg citalopram for two and a half years. I am 22 months into the HIMS AME submission process with my case currently in DC, scheduled to be out in October.

My wife and I had a stressful time in our lives back in January 2021 (brand new baby and we had to sell her family business). She was having a really rough time and got a prescription for Xanax as needed from our GP. I got one as well, thinking, "well, maybe this will help me relax. Why not?" GP said sure. I tried it three times and it didn't do anything for me so I discontinued immediately.

My HIMS AME is not concerned about this, specifically due to the short duration. He said "If someone is currently on more than one drug for depression, anxiety, they will not be considered. If in the past, they had trials of other non-approved drugs or had been on more than one drug, but now they are on a single acceptable medication, they will be considered." This is not my reading of the SSRI guidelines at all, but he should know better than I would. But your description of it as a marker of severity makes sense and has me very concerned.

Is this generally an immediate denial by DC or do they exercise any judgment here? (Is it at all promising that it made it out of OKC after a year and a half or would it do that before a denial from DC regardless?)

....With regard to supplemental benzos, It's all in how the record reads, the intent of the prescriber, and the usage as determin by "rate of pharmacy Rx" record.... And, if it's made the hurdls and gotten to DC, you've made it past the prelim screening!

 

[Andy Bader]

That's such a relief to hear, thank you! I'm just glad to hear it's not an automatic big red "NO" stamped on there. Fingers crossed for the best. Thanks Dr. Chien!