Just Prescribed Prozac -- Looking for Advice

[Unregistered]

Hello. I completed about 32 hours towards a Private Pilot Certificate 3 years ago. I am self-employed and when the economy crashed I had to go into conservation mode and chose to stop flying until the economy recovered. I am seriously considering beginning flying again and pursuing a Sport Pilot Certificate, as I feel it will fulfill all the needs and wants I will have as a pilot. A little over one year ago I had to make a trip to the ER in the middle of the night due to a rapid heart rate. Prior to this episode I had never had any serious health issues. Docs determined I had an underactive Thyroid and prescribed a small daily does of Levothyroxine to get my levels back to normal. It has been just over one year and my thyroid levels have been normal, but I recently began feeling lethargic and have had some anxiety at night that has affected my sleeping. I told the doc, as I thought maybe my Thyroid meds needed to be adjusted, but after bloodwork and and exam, I seem to be in perfect physical health. To my surprise, the doc prescribed Prozac and assured me that I would feel better with it's use. I am just dumbfounded about this, and it comes at a time that I was just going to begin training again in pursuit of a Sport Pilot Certificate... I believe that all that is needed for Sport is a driver's license... so do I just keep it under my hat that I am on Prozac. Should I just not pursue flying now? Are there effects that could make me an unsafe Sport Pilot while on Prozac? Any advice is appreciated. I will not pursue flying if I will become a danger to myself or others... I'm just at a loss right now on what to do. Thanks for any help.

 

[murphey]

1. Do not ever lie on an FAA medical form. It will come back to haunt you. Lie neither by omission nor comission.
2. Is the doctor who prescribed the prozac your regular physician? Does he/she understand that you wish to continue with your flight instruction?
3. The FAA has started to annoy everyone on synthroid for an annual blood test. As if we didn't have enough paperwork to do for them.
4. Wait for Dr Bruce to respond with his opinion. Then pay attention to him!!!!

 

[AggieMike88]

And don't fill the script until Dr. Bruce weighs in.

It's easy to hand back the bit of paper with the prescription. Not as easy to unwind the pills in hand.

 

[Capt. Geoffrey Thorpe]

The most important thing in your life is your third class medical. Health and mental well being are a distant second. Denial can keep you medical intact for quite a while - at least until someone finds you unconscious on the floor of an FBO men's room.


However, if you are willing to settle for being low life baby eating sport pilot scum, you should consult with your doctor about your ability to safely act as PIC with / without the medication as well as what specific issues he is prescribing the medication for. Taking Prozac can have serous implications for any future FAA medical and if there is no real reason...

There is no need to "keep it under your hat" - just don't apply for a medical. But do consult your doctor. Perhaps getting a second opinion would be in order.

 

[Geico266]

Don't take it. IMHO Dr's are way to fast to prescribe anti anxiety drugs. Try exercising, meditation, reading, eating better, exercise, exercise, exercise, first. Do not take Prozac unless it is the last resort.

JMHO.

 

[Gary F]

Don't take it. IMHO Dr's are way to fast to prescribe anti anxiety drugs. Try exercising, meditation, reading, eating better, exercise, exercise, exercise, first. Do not take Prozac unless it is the last resort.

JMHO.

If you are not inclined to take a prescribed med it is best to discuss this with the physician before you leave the office with the script. Let the physician know that you are a pilot with FAA medical issues and this medication is verboten. By the time the doc dictates the note there may be serious implications if the FAA ever gets a hold of it. A conscientious doc would be careful about what is in the dictation. I agree that meds are over-prescribed, especially antibiotics and anti-depressants. Many patients are extremely disappointed if they leave without a Rx for a prescription med for every complaint.

 

[AdamZ]

If you are not inclined to take a prescribed med it is best to discuss this with the physician before you leave the office with the script. Let the physician know that you are a pilot with FAA medical issues and this medication is verboten. By the time the doc dictates the note there may be serious implications if the FAA ever gets a hold of it. A conscientious doc would be careful about what is in the dictation. I agree that meds are over-prescribed, especially antibiotics and anti-depressants. Many patients are extremely disappointed if they leave without a Rx for a prescription med for every complaint.

Excellent Response Gary!! Also wait for Bruce to chime in regarding what you can/must do with regard to the FAA if you are on an SSRI.

 

[tonycondon]

Don't take it. IMHO Dr's are way to fast to prescribe anti anxiety drugs. Try exercising, meditation, reading, eating better, exercise, exercise, exercise, first. Do not take Prozac unless it is the last resort.

JMHO.

have you ever lived with someone having anxiety issues?

 

[poadeleted20]

Are there effects that could make me an unsafe Sport Pilot while on Prozac?

That is probably the most important question you've asked if flying as a Sport Pilot is your goal. The regulations say that a DL alone is not sufficient -- you must also be able to fly safely. That is a matter which the Federal Air Surgeon says you should discuss with your own physician who is familiar with all aspects of your medical condition and any medications you are taking. So what does your doc say?

 

[Geico266]

have you ever lived with someone having anxiety issues?

Yes, and prescribed meds for it. They do not work long term, they are a temporary crutch IMHO. Better to confront the real problem and make the life changes needed to get over the anxiety.

Exercise and diet worked for us. No meds...... Is Bud Lite a med?


Obviously, every case is different. In general anti depression drugs are way over prescribed as "mother's little helper". (Rolling Stone's song.)

"Kids are different today, I hear ev'ry mother say
Mother needs something today to calm her down
And though she's not really ill, there's a little yellow pill
She goes running for the shelter of a mother's little helper
And it helps her on her way, gets her through her busy day ”


http://m.youtube.com/#/watch?desktop_uri=/watch?v=f0U95Aj783s&v=f0U95Aj783s&gl=US

 

[murphey]

If you are not inclined to take a prescribed med it is best to discuss this with the physician before you leave the office with the script. Let the physician know that you are a pilot with FAA medical issues and this medication is verboten. By the time the doc dictates the note there may be serious implications if the FAA ever gets a hold of it. A conscientious doc would be careful about what is in the dictation. I agree that meds are over-prescribed, especially antibiotics and anti-depressants. Many patients are extremely disappointed if they leave without a Rx for a prescription med for every complaint.

Best response here!

At least until Dr Bruce stops by.

 

[Gary F]

SSRIs like Prozac and Paxil have a sexual side effect which has been exploited by urologists to treat guys who are too quick in the sack. I doubt that the FAA would approve this use for the drug so pilot's wives and girlfriends will have to deal with it or go elsewhere.

 

[murphey]

Yes, and prescribed meds for it. They do not work long term, they are a temporary crutch IMHO. Better to confront the real problem and make the life changes needed to get over the anxiety.

Exercise and diet worked for us. No meds...... Is Bud Lite a med?

Obviously, every case is different. In general anti depression drugs are way over prescribed as "mother's little helper". (Rolling Stone's song.)

I agree that certain meds are overprescribed. But unless you are a physician or pharmacologist specializing in this field, your anectodal evidence is just that. Anecdotal. Worked for you? mazel tov. But don't resort to the Tom Cruise Philosophy of Medicine and proclaim that you're right and everyone else is wrong.

 

[bbchien]

Hello. I completed about 32 hours towards a Private Pilot Certificate 3 years ago. I am self-employed and when the economy crashed I had to go into conservation mode and chose to stop flying until the economy recovered. I am seriously considering beginning flying again and pursuing a Sport Pilot Certificate, as I feel it will fulfill all the needs and wants I will have as a pilot. A little over one year ago I had to make a trip to the ER in the middle of the night due to a rapid heart rate. Prior to this episode I had never had any serious health issues. Docs determined I had an underactive Thyroid and prescribed a small daily does of Levothyroxine to get my levels back to normal. It has been just over one year and my thyroid levels have been normal, but I recently began feeling lethargic and have had some anxiety at night that has affected my sleeping. I told the doc, as I thought maybe my Thyroid meds needed to be adjusted, but after bloodwork and and exam, I seem to be in perfect physical health. To my surprise, the doc prescribed Prozac and assured me that I would feel better with it's use. I am just dumbfounded about this, and it comes at a time that I was just going to begin training again in pursuit of a Sport Pilot Certificate... I believe that all that is needed for Sport is a driver's license... so do I just keep it under my hat that I am on Prozac. Should I just not pursue flying now? Are there effects that could make me an unsafe Sport Pilot while on Prozac? Any advice is appreciated. I will not pursue flying if I will become a danger to myself or others... I'm just at a loss right now on what to do. Thanks for any help.

The answer depends on two things:

(1) Do you ever think you will want a PVT ASEL? If the answer is no, then Prozac is not relevant. Note, this is like asking a divorced 35 y.o. woman if she wants her tubes tied. She has it done. Later, often she meets the "Right" guy and want to have kids at age 40. Now what? the reversal rate of success is what- 40%?

So be careful before you answer "no". The minute you fill that Rx you have a world of hurt in front of you before you can get a class 3 medical for flying PVT ASEL. I'm talking $2,500 of evaluation 180 days off the meds and hoping for a negative evaluation by a State licensed Ph.D. Psychologist, standing between you and getting 3rd class privileges back. EVER.

(2) For LSA operation, you and your doc have to weigh the "are you better with prozac or are you not?" question.

My personal opinion is that if you are having anxiety issues it's best to NOT fly. The Pappas accident really affected me (Yamhill OR checkout SEA05FA125 PTSD is but one of the anxiety disorders.). One never knows when a hesitation will result in "all is lost". But that is between you and your personal doctor.

 

[Unregistered]

Thank you Dr. Bruce, your advice and insight is invaluable, and as usual, presented in a clear and direct to the point manner. Thank you.

 

[AdamZ]

The MC would like to remind people that Medical Topics is a serious forum where pilots need to feel free to discuss their medical issues
anonymously and not be mocked.
Use of the anon feature to crack jokes or do anything but post legitimate personal information or experiences in the Medical Topics forum is a violation of the ROC.

 

[TMetzinger]

Bruce?

If a pilot's (with a medical) physician prescribes something like this during an all-too-typical rushed consultation, can the pilot not fill the prescription, send it back to the prescribing doc with some sort of communication saying "I really need to try another route before medication due to my flying" and be ok with the FAA?

Let's assume that either the issue isn't something the pilot would self-ground for, or it IS and the pilot self-grounds until the issue is resolved.

At the next renewal, if the pilot lists the visit, notes no medications, and tells the AME about the issue and how it was resolved without medications, is he likely to get issued?

I guess at the root of the matter I'm asking is the PRESCRIPTION of the medicine disqualifying, or is the USE of the medicine disqualifying, or both?

I have seen things that make me think that GP's sometimes diagnose adults with "depression" the same way that school guidance counselors diagnose kids with ADD.

 

[denverpilot]

I went the opposite tactic with my GP.

I told him to make a note in my chart to never write me a script without asking me first due to the people at the FAA...

... who I explained to him, themselves need a little Mental Health counseling ...

For all their worry about all us falling apart pilots who are careening out of the sky into children's playgrounds, hourly, killing millions.

Millions I tell you!

He laughed. It's on my chart. Easy.

 

[murphey]

I went the opposite tactic with my GP.

I told him to make a note in my chart to never write me a script without asking me first due to the people at the FAA...

... who I explained to him, themselves need a little Mental Health counseling ...

For all their worry about all us falling apart pilots who are careening out of the sky into children's playgrounds, hourly, killing millions.

Millions I tell you!

He laughed. It's on my chart. Easy.

I, too, have made it clear to my PP that no prescriptions until I check with an AME. Fortunately, the PP is a retired USAF Flight Surgeon and understands.

 

[Skip Miller]

can the pilot not fill the prescription, send it back to the prescribing doc with some sort of communication saying "I really need to try another route before medication due to my flying" and be ok with the FAA?

Yes the pilot can do that. It is the usage, not the paper.

However (as is true with many other facets of FAA Buraucracy), if there is no paper it didn't happen. The reverse is also true - if there IS paper, it did happen. So you need to send your communication to the Doc certified return receipt requested. If you filled the prescription but haven't taken any pills, take them back to the Doc's office, have the nurse count the pills in your presence, and watch her make an entry in your record that you turned in x number of pills. So... CYA!

-Skip

 

[bbchien]

Yes the pilot can do that. It is the usage, not the paper.

However (as is true with many other facets of FAA Buraucracy), if there is no paper it didn't happen. The reverse is also true - if there IS paper, it did happen. So you need to send your communication to the Doc certified return receipt requested. If you filled the prescription but haven't taken any pills, take them back to the Doc's office, have the nurse count the pills in your presence, and watch her make an entry in your record that you turned in x number of pills. So... CYA!

-Skip

EXACTLY CORRECT. You create a medical record entry at the doctors', that counters the prescription, the fulfillment thereof.....to oppose the financial record of the prescription being filled.

 

[Unregistered]

This is for Dr. Bruce. I have been on SSRI's for a long time (several years). It is very rare for me to have any depression symptoms or side effects from my medication. I haven't seen a psychiatrist in years because the medication works well with no problem. When the FAA approved SSRI use almost 2 years ago I went to get a third class medical so I could get a student pilot license. The AME was uninformed of SSRI approval and of course did not know what tests were involved with getting an SI. I received a letter from FAA Oklahoma City advising me I had to get a consultation from a treating psychiatrist (I don't go to any psychiatrists any more) and I had to take some very expensive tests (A report of the results of neurocognitive psychological tests, including, but not limited to, COGSCREEN AE; Trails A/B; Stroop Test; CCPT; PASSAT; Wisconsin Card Sorting Test. All raw data from those tests must be included.) $$$$$

Ok I don't have the money for all those tests. Why does the FAA want me to take six cognitive tests for a third class medical. That was in June 2010. I eat my heart out every time I pass an airport that I can't get a medical unless I have big bucks and can jump thru high hoops.

Has there been any changes to this requirement? This is so unnecessary and downright cruel. This is going to kill GA. All I want to do is fly single engine airplanes, I don't want to be an airline pilot, I just want to fly for fun.

What should I do?

 

[Gary F]

This is for Dr. Bruce. I have been on SSRI's for a long time (several years). It is very rare for me to have any depression symptoms or side effects from my medication. I haven't seen a psychiatrist in years because the medication works well with no problem. When the FAA approved SSRI use almost 2 years ago I went to get a third class medical so I could get a student pilot license. The AME was uninformed of SSRI approval and of course did not know what tests were involved with getting an SI. I received a letter from FAA Oklahoma City advising me I had to get a consultation from a treating psychiatrist (I don't go to any psychiatrists any more) and I had to take some very expensive tests (A report of the results of neurocognitive psychological tests, including, but not limited to, COGSCREEN AE; Trails A/B; Stroop Test; CCPT; PASSAT; Wisconsin Card Sorting Test. All raw data from those tests must be included.) $$$$$

Ok I don't have the money for all those tests. Why does the FAA want me to take six cognitive tests for a third class medical. That was in June 2010. I eat my heart out every time I pass an airport that I can't get a medical unless I have big bucks and can jump thru high hoops.

Has there been any changes to this requirement? This is so unnecessary and downright cruel. This is going to kill GA. All I want to do is fly single engine airplanes, I don't want to be an airline pilot, I just want to fly for fun.

What should I do?

This makes sense for first class and possibly second class but I think it is ridiculously onerous for a third class medical. People still (rarely) commit suicide by plane even with valid medical certificates and you can still jump in a plane and kill yourself even without one. I agree that an assessment for mental conditions is warranted but I think the standards are a little over the top for a third class certificate.

 

[Capt. Geoffrey Thorpe]

Ok I don't have the money for all those tests. Why does the FAA want me to take six cognitive tests for a third class medical. That was in June 2010. I eat my heart out every time I pass an airport that I can't get a medical unless I have big bucks and can jump thru high hoops.

Has there been any changes to this requirement? This is so unnecessary and downright cruel. This is going to kill GA. All I want to do is fly single engine airplanes, I don't want to be an airline pilot, I just want to fly for fun.

What should I do?

Sadly, the options are pretty much the ones already presented to you. Had you avoided applying for the medical, and if you and your doctor had agreed that you were safe to operate as PIC of a light sport airplane, that would have been an option. Now that one is out.

One other option (again after discussion with your doctor) would be gliders - including self launch gliders. for example: http://www.ximangousa.com/

But other than that. Sorry.

This makes sense for first class and possibly second class but I think it is ridiculously onerous for a third class medical. People still (rarely) commit suicide by plane even with valid medical certificates and you can still jump in a plane and kill yourself even without one. I agree that an assessment for mental conditions is warranted but I think the standards are a little over the top for a third class certificate.

That's why it is so important to remain in denial and not get help with mental health issues. That way you can retain your medical until it is too late.

 

[steingar]

A bit of science. Fluoxetine, whose best known trade name is indeed Prosac, inhibits the reuptake of the neurotransmitter Seratonin, which can control things like mood and personality. Altering the level at which Seratonin acts can affect certain aspects of personality. It also affects levels of other neurotransmitters in the brain, though the mechanism by which it does this is not entirely clear. Of interest, it is the same mechanism of action of drugs like Ecstasy, though the latter is quite dangerous as it kills the nerve cells on which it acts.

The last big study I saw of the drug's efficacy showed it was no better than a placebo. That could simply be due to the difficulty in measuring the effect, since said effect is entirely subjective.

I would not encourage anyone disregard their physician's advice. You health is far more important than your pilot's license. However, I would question the physician if there was another treatment that would achieve the goal in an FAA sanctioned fashion.

As an aside note (and to assuage my own considerable ego) I likely carry a mutation at the promoter for the seratonin uptake inhibitor, making me preternaturally happy. Mrs. Steingar is thus in no need of Fluoxetine, as she has me.


This latter bit will likely be quite counterintuitive to those who know me.

 

[Gary F]

A bit of science. Fluoxetine, whose best known trade name is indeed Prosac, inhibits the reuptake of the neurotransmitter Seratonin, which can control things like mood and personality. Altering the level at which Seratonin acts can affect certain aspects of personality. It also affects levels of other neurotransmitters in the brain, though the mechanism by which it does this is not entirely clear. Of interest, it is the same mechanism of action of drugs like Ecstasy, though the latter is quite dangerous as it kills the nerve cells on which it acts.

The last big study I saw of the drug's efficacy showed it was no better than a placebo. That could simply be due to the difficulty in measuring the effect, since said effect is entirely subjective.

I would not encourage anyone disregard their physician's advice. You health is far more important than your pilot's license. However, I would question the physician if there was another treatment that would achieve the goal in an FAA sanctioned fashion.

As an aside note (and to assuage my own considerable ego) I likely carry a mutation at the promoter for the seratonin uptake inhibitor, making me preternaturally happy. Mrs. Steingar is thus in no need of Fluoxetine, as she has me.


This latter bit will likely be quite counterintuitive to those who know me.

Placebo has fewer side effects so that might be a better choice.

 

[Henning]

Before you go on prozac test your testosterone.

 

[steingar]

Placebo has fewer side effects so that might be a better choice.

What I saw was awfully damning, but I really wasn't sold. It is very hard to put quantitative measures on something like mood.

I would think that the nervous system would react in a compensatory fashion, though Fluoxetine is a potent inhibitor of the Cytochrome enzyme that metabolizes it to it's pharmacologically active form. I would imagine this could set up a feedback cycle to modulate its levels and prevent compensation. However, my knowledge of monoamine uptake inhibitor pharmacokinetics is admittedly lacking.

 

[Gary F]

What I saw was awfully damning, but I really wasn't sold. It is very hard to put quantitative measures on something like mood.

I would think that the nervous system would react in a compensatory fashion, though Fluoxetine is a potent inhibitor of the Cytochrome enzyme that metabolizes it to it's pharmacologically active form. I would imagine this could set up a feedback cycle to modulate its levels and prevent compensation. However, my knowledge of monoamine uptake inhibitor pharmacokinetics is admittedly lacking.

Modifying one chemical pathway in the brain is a horribly crude intervention. I have come across other studies which cast doubts on SSRIs but plenty of physicians and patients swear by them. Unfortunately some antidepressants are associated with an increased risk of suicide in children and young adults.

 

[steingar]

Modifying one chemical pathway in the brain is a horribly crude intervention.

Utterly true. I think it falls under the rubric of finding a chemical that has more palliative effect than side effect and using it. I strongly doubt anyone really knows what the stuff is doing.

I have come across other studies which cast doubts on SSRIs but plenty of physicians and patients swear by them.

I begin to wonder how much popular culture is now playing into it. I have read that Monoamine uptake inhibitors are over-prescribed nearly as much as antibiotics.

Unfortunately some antidepressants are associated with an increased risk of suicide in children and young adults.

I suspect we're reading the same papers. Back to what you said, a crude intervention, and what is it really doing? What is the relationship between monoamine levels in the CNS and a complex behavior like suicide?

That's why I counsel a long talk with the physician before taking the stuff. If you really need it, fine. Health beats airplanes every time. But the illness isn't life-threatening, and from what was posted this is more of a palliative, and not curative intervention. Trying an alternative therapy (of which there are quite a few for anxiety) would not seem at first blush to have such a big down side, but could potentially have a huge up side.

 

[bbchien]

Only slightly less crude than ECT, which continues to be use for refractory depression(s).

 

[Jeanie]

They are still using ECT? I'm a little surprised by that. I was counseling a state psych patient once who was slated for ECT but then decided against it. Don't know whatever happened to her.
The suicide thing as far as I know a little bit about it ( secondary to chats with docs in the biz.) is that after the meds have started working, a person who has been very depressed finally feels well enough to "do" something and will sometimes act on their suicidal inclinations. Simply prescribing meds without concomitant therapy isn't complete help.
Granted it's very complex, I realize that, so don't jump me about making some simple statements, please.

 

[Jeanie]

Awareness meditation can help with some levels of anxiety.
If you want more info or references please feel free to email or PM me. Confidentiality applies

 

[Henning]

They are still using ECT? I'm a little surprised by that.

Why? I always kinda liked getting electrocuted....

 

[Clark1961]

Why? I always kinda liked getting electrocuted....

You may not be NorMal!

 

[SCCutler]

Excellent information here. Thanks, all.

 

[onwards]

The answer depends on two things:

(1) Do you ever think you will want a PVT ASEL? If the answer is no, then Prozac is not relevant. Note, this is like asking a divorced 35 y.o. woman if she wants her tubes tied. She has it done. Later, often she meets the "Right" guy and want to have kids at age 40. Now what? the reversal rate of success is what- 40%?

So be careful before you answer "no". The minute you fill that Rx you have a world of hurt in front of you before you can get a class 3 medical for flying PVT ASEL. I'm talking $2,500 of evaluation 180 days off the meds and hoping for a negative evaluation by a State licensed Ph.D. Psychologist, standing between you and getting 3rd class privileges back. EVER.

What are you talking about?

I got my third class medical without $2500 expenses or a state PhD or anything of the sort - and I fully disclosed that I had also been on an SSRI for two months about a year and half prior to my application.

All it took was my explaining precisely why I was prescribed it (combination of temporary life events related to and driven by the financial meltdown). The Oklahoma office never even asked for anything beyond a letter from me explaining it. That's ALL it took.

Note that I also happen to be an insulin-dependent diabetic, and THAT was a pain in the behind to get through. But the SSRI was practically a non-issue.

EDIT: I looked back because I couldn't remember the name of the drug, but I found it. It's called Cymbalta. I filled it twice and used it for 60 days.

FURTHER EDIT: looking more stuff up. Cymbalta is apparently an SNRI, not SSRI - not that I fully understand the difference, but apparently there is one, maybe such that the FAA cares less about it? also, Dr. Bruce, I was mostly taken by surprise, no disrespect intended in my post above. I think the diabetes triggered a much bigger question than a one-time 60-day period on an anti-depressant fully justified by pretty difficult life events.

 

[bbchien]

AMEs have the authority, if they can determine the exposure was less than 6 months, to determine that there is no underlying long term diagnosis, and issue.

I believe that all that is needed for Sport is a driver's license... so do I just keep it under my hat that I am on Prozac. Should I just not pursue flying now? Are there effects that could make me an unsafe Sport Pilot while on Prozac?

This post hardly says less than six month's exposure.

What are you talking about?

I got my third class medical without $2500 expenses or a state PhD or anything of the sort - and I fully disclosed that I had also been on an SSRI for two months about a year and half prior to my application.

All it took was my explaining precisely why I was prescribed it (combination of temporary life events related to and driven by the financial meltdown). The Oklahoma office never even asked for anything beyond a letter from me explaining it. That's ALL it took.

You should read the OP in a string before coming out swinging like that. You look silly.

 

[onwards]

[to me]

You should read the OP in a string before coming out swinging like that. You look silly.

Yes, indeed, admitted. Guilty (and silly) as charged. Sorry about that. I was really just reacting in surprise to something that seemed to completely negate my own experience, forgetting for the moment that in a forum, no one can see my face Apologies.

 

[Unregistered]

"The last big study I saw of the drug's efficacy showed it was no better than a placebo. That could simply be due to the difficulty in measuring the effect, since said effect is entirely subjective."

This is total bull****. Prozac (spelled correctly) works. (If you can't spell it then you must not have much knowledge of it) It works for me I feel fine. Don't judge something you have never experienced. There is so much ignorance regarding treatment of depression and antidepressants. People are so quick to judge someone for a condition they have not experienced. The FAA's medical policy is a sad joke. They don't care if someone has to spend $8000 every two years to maintain a third class medical yet they don't even drug test pilots when they go for their medicals. People who are alcoholics/DWI get better treatment than people who take SSRI's. Try finding a psychiatrist who understands why the FAA wants tests and what should be in the evaluations. They set up all these expensive hoops to jump through yet they don't have the infrastructure in place to do these examinations. They don't require much of the AME's as far as continuing education. Some of them aren't even aware that SSRI's are "allowed". Now I know why many pilots just don't report their SSRI use. It's not worth all the hassle.



I