Just had AME 1st Class deferred could use advice

[Wanna Fly]

So I was considering going to flight school and was recommended to first do the medical before anything, and I did that today but I was deferred because I take Wellbutrin for mild depression. I used to take SSRI's but switched to Wellbutrin as it had less side effects.

I've read a post on here that isn't very optimistic for my chances. Does anyone know what I can do to clear the medical? I don't have to be on Wellbutrin, I could switch and deal with the side effects of something that will be ok, and I am not even sure I still need to take anything, it's just been the status quo for so long.

Any advice is much appreciated.

 

[Anthem]

You are probably going to have to be off of it and go through the psych screens (COGS). The other docs can advise but it won’t be fast and it won’t be cheap. If you intend to overcome this - be prepared to lay our 4-6k in psych HIMS ame tests to prove you are capable or safely flying

 

[Wanna Fly]

You are probably going to have to be off of it and go through the psych screens (COGS). The other docs can advise but it won’t be fast and it won’t be cheap. If you intend to overcome this - be prepared to lay our 4-6k in psych HIMS ame tests to prove you are capable or safely flying

Wow, that's a lot of money just because I changed to Wellbutrin to avoid weight gain issues with an SSRI. How long would it take?

And thanks for the response. I appreciate it even though it's dejecting to hear.

 

[Daleandee]

Not a doc but from what I've read posted here before I believe the SSRI and the reason for the SSRI is where the concern is ...

Edit to add: https://www.faa.gov/about/office_or...process/exam_tech/item47/amd/antidepressants/

 

[Anthem]

Wow, that's a lot of money just because I changed to Wellbutrin to avoid weight gain issues with an SSRI. How long would it take?

And thanks for the response. I appreciate it even though it's dejecting to hear.

It’s not Wellbutrin (which they don’t like) but ANY mind altering drugs (ssri, etc ). So don’t focus on the Wellbutrin as that isn’t it - it’s the anxiety/depression prescription drugs. Once you have the DX, you now have to prove to the FAA that you are fit to fly. And the cost doesn’t guarantee anything - it’s just the costs for the specialists and tests to render that ruling

 

[Wanna Fly]

It’s not Wellbutrin (which they don’t like) but ANY mind altering drugs (ssri, etc ). So don’t focus on the Wellbutrin as that isn’t it - it’s the anxiety/depression prescription drugs. Once you have the DX, you now have to prove to the FAA that you are fit to fly. And the cost doesn’t guarantee anything - it’s just the costs for the specialists and tests to render that ruling

Is it possible to overcome, or is the process really amounting to a waste of time?

 

[Anthem]

Is it possible to overcome, or is the process really amounting to a waste of time?

Plenty have. But not generally while on it. You will want to read through the forums on it. And contact and retain one of the 3 AMEs that are used to dealing with difficult cases to help you through it. Dr Chien, dr Fowler and wingman med.

But be prepared - it will run you a minimum of 5k to go through the gauntlet. You’re committed down this path if you want to fly as the other options like sport pilot and such are no longer options for you since you have already stated the medical process and you can’t stop or take it back.

 

[Wanna Fly]

Plenty have. But not generally while on it. You will want to read through the forums on it. And contact and retain one of the 3 AMEs that are used to dealing with difficult cases to help you through it. Dr Chien, dr Fowler and wingman med.

But be prepared - it will run you a minimum of 5k to go through the gauntlet. You’re committed down this path if you want to fly as the other options like sport pilot and such are no longer options for you since you have already stated the medical process and you can’t stop or take it back.

Thanks for the info. Really appreciate it. Which of the three would you recommend me choosing? Is there a difference? I am located in Florida.

 

[Anthem]

Thanks for the info. Really appreciate it. Which of the three would you recommend me choosing? Is there a difference? I am located in Florida.

I can’t recommend any of them as I didn’t use any of them. All three are fairly good responders on this forum so my hats off to all of them for contributing their time. Dr Chien seems to be well versed in the HIMS space on these things as it looks to be his speciality. I believe he is out of the Chicago area. I think for you - you first have to make the determination that you definitely want to pursue this even though it will Cost north of 5k and a year before throwing more $$$ at it. Then retain a specialist and he will Guide you through the HIMS Cogscreen process. But even before that - read through and do your research. If you had don’t that beforehand - you wouldn’t be in the predicament you are in now

 

[Half Fast]

Thanks for the info. Really appreciate it. Which of the three would you recommend me choosing? Is there a difference? I am located in Florida.

Dr. Lou Fowler is in Pensacola and handles challenging cases like yours. Paging @lbfjrmd

Dr. Bruce Chien is in Illinois, so farther away but he is one of the physicians who authored the FAA protocol for SSRI use. Paging @bbchien

Either one would be a good choice. You might want to discuss things with both before you do anything further.

 

[Wanna Fly]

I can’t recommend any of them as I didn’t use any of them. All three are fairly good responders on this forum so my hats off to all of them for contributing their time. Dr Chien seems to be well versed in the HIMS space on these things as it looks to be his speciality. I believe he is out of the Chicago area. I think for you - you first have to make the determination that you definitely want to pursue this even though it will Cost north of 5k and a year before throwing more $$$ at it. Then retain a specialist and he will Guide you through the HIMS Cogscreen process. But even before that - read through and do your research. If you had don’t that beforehand - you wouldn’t be in the predicament you are in now

Thanks. Yeah this seems pretty bad.

 

[Wanna Fly]

Dr. Lou Fowler is in Pensacola and handles challenging cases like yours. Paging @lbfjrmd

Dr. Bruce Chien is in Illinois, so farther away but he is one of the physicians who authored the FAA protocol for SSRI use. Paging @bbchien

Either one would be a good choice. You might want to discuss things with both before you do anything further.

Thank you!

 

[Half Fast]

Thanks. Yeah this seems pretty bad.

Don’t give up until you’ve spoken with the recommended AMEs. Wellbutrin is prohibited so the FAA will likely issue a denial and you’ll have to start over. Get some AME advice before doing that. This is probably solvable with time and money, and I’m sorry to tell you but that’s what aviation is like.

(Aviation expenses are often stated in AMUs, where 1 AMU = $1,000.)

Your first AME should have explained the situation before going live with the exam. He didn’t do you a favor.

 

[Wanna Fly]

Your first AME should have explained the situation before going live with the exam. He didn’t do you a favor.

Yeah they didn't tell me until after everything was done. They only told me I'd be deferred and would need to submit additional info and I should be fine.

I think I am smoked.

 

[Half Fast]

See https://www.faa.gov/about/office_or...process/exam_tech/item47/amd/antidepressants/

 

[WingmanMed]

@Wanna Fly I am sorry to hear about your issues. Wellbutrin is indeed a prohibited medication as it has a significantly higher risk of suicide compared to the accepted SSRI medications. And while that may not be true for your case, the FAA simply isn't willing to take that bet.

You effectively have two choices on your path to a medical certification:

1. You stop all medication. Given your history of different medications, your exam would have been deferred regardless and you will need to provide the FAA with a pretty decent amount of historical information plus and updated evaluation that meets the FAA's guidelines before they decide on an answer.

2. You switch to one of the approved SSRI medications, you go through the process of the psychiatric and neuropsychological evaluations and then you sit and wait many months (12-15 is our current estimate from start to end) to find out if you get your certificate. The good news is that if you pass all of the evaluations and have good reports from the physicians then you will get your medical. The bad news is that it takes a long time, costs a decent amount of money and if you don't pass then you won't get your certificate.

 

[Wanna Fly]

@Wanna Fly I am sorry to hear about your issues. Wellbutrin is indeed a prohibited medication as it has a significantly higher risk of suicide compared to the accepted SSRI medications. And while that may not be true for your case, the FAA simply isn't willing to take that bet.

You effectively have two choices on your path to a medical certification:

1. You stop all medication. Given your history of different medications, your exam would have been deferred regardless and you will need to provide the FAA with a pretty decent amount of historical information plus and updated evaluation that meets the FAA's guidelines before they decide on an answer.

2. You switch to one of the approved SSRI medications, you go through the process of the psychiatric and neuropsychological evaluations and then you sit and wait many months (12-15 is our current estimate from start to end) to find out if you get your certificate. The good news is that if you pass all of the evaluations and have good reports from the physicians then you will get your medical. The bad news is that it takes a long time, costs a decent amount of money and if you don't pass then you won't get your certificate.

Thank you for your help. And I get it. They don't want a suicidal person crashing into a mountain. I wouldn't want to fly in a plane if I thought the pilot was potentially suicidal.

If I did route 1, how long would I have to go before potentially getting a cert? I also sent in my info on your website.

 

[WingmanMed]

Route 1 is not easy. There are still many steps and the right documentation is needed. If you do everything correctly, and everything looks good, it will still take about 6-12 months.

 

[FatherPilot]

I successfully went through the deferred SSRI process after stopping use of them. It was pretty straightforward but took 6 months before I got a Special Issuance third class in hand. Be aware that all medical records get submitted; anything you said in confidence years ago to a therapist/psychiatrist will get sent to Oklahoma for review. Any mention of suicide ideation, alcohol abuse, other illicit drug use will complicate your quest.

 

[AggieMike88]

Dr Chien seems to be well versed in the HIMS space on these things as it looks to be his speciality.

That’s because he was one of the 4 AME’s who authored the protocol that changed how SSRI’s are viewed by the FAA.

 

[AggieMike88]

I wouldn't want to fly in a plane if I thought the pilot was potentially suicidal.

Unfortunately the passengers of Germanwings Flight 9525 didn’t get that choice.

Also google Andreas Lubitz who was the pilot of that flight.

This incident is one of the reasons the FAA is so twitchy about mental health.

 

[bbchien]

The key here is understanding that either long-standing disorders, or recurrent disorders, untreated and unmonitored, are 100% denied.

…and there are limitations to the “on SSRI” path as well.

 

[Wanna Fly]

Unfortunately the passengers of Germanwings Flight 9525 didn’t get that choice.

Also google Andreas Lubitz who was the pilot of that flight.

This incident is one of the reasons the FAA is so twitchy about mental health.

Given that he hid his issues, it appears to indicate these policies backfire if they encourage people to not get treatment or lie.

 

[FatherPilot]

Given that he hid his issues, it appears to indicate these policies backfire if they encourage people to not get treatment or lie.

Bingo. After my experience, I now see all medical professionals as unofficial agents of the FAA. I will be very careful in how I receive care going forward.

 

[Wanna Fly]

Bingo. After my experience, I now see all medical professionals as unofficial agents of the FAA. I will be very careful in how I receive care going forward.

They hand this stuff out like candy and you don't realize the stigma attached to it. But what can you do? Now it appears I have to take an SSRI otherwise it looks like I am not treating a condition.