Newbie tampering off SSRI, should I even try?

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learnin2fly

Filing Flight Plan
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learnin2fly
Hi, I'm 40 and with zero experience, life long dream to become a pilot. I've been reading all about the medical. My history, in 2018 I took Lexapro for mild anxiety, tampered off in 2020. Now in Jan 2024, new doctor suggested it again, been on it for 3 months but beginning to tamper off because don't really need it. I'll plan to begin my medical in a few months, so I will be off it for more than 60 days by the time I visit the AME.

I don't mind getting deferred but is my situation a 100% deal breaker?
 
I believe because you have a history of going off and then on - it’ll be ssri patheay 2. Obviously the docs on here will be better to advise. It can be done but it’s going to be costly and onerous. If you only plan on recreationally flying you may want to consider the sport option.
 
2-Bit Speed said:
I'll admit, I read the title about tampering with medical issues and was getting ready to shout...
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Aghh that's embarrassing ! so sorry for the typo
Anthem said:
I believe because you have a history of going off and then on - it’ll be ssri patheay 2. Obviously the docs on here will be better to advise. It can be done but it’s going to be costly and onerous. If you only plan on recreationally flying you may want to consider the sport option.
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Bummer, it'd suck if this is the case.
 
One just requires you to stay on and the other is testing with it off. It’s not like one is so much easier than the other one. If you think you got off and you could get through without either pathway I think that option isn’t available to you as it wasn’t one time and wasn’t short term.
 
My confusion then comes from this, the entry point is "is ON anti-depressant", which I'm not. But for the sake of the argument, lets continue on the top row, I discontinued, and AME notes in block 60, after 60 days with favorable rpeort I can reapply for "regular issuance".

How much in $$$ and time is it to go through either of the paths?
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learnin2fly said:
My confusion then comes from this, the entry point is "is ON anti-depressant", which I'm not. But for the sake of the argument, lets continue on the top row, I discontinued, and AME notes in block 60, after 60 days with favorable rpeort I can reapply for "regular issuance".

How much in $$$ and time is it to go through either of the paths?
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You're potentially mis-representing or mis-interpreting that. It isnt just "ON" based on what you can determine to be on or off, or when you are on or off. There is a medical term, where if you are prescribed and you cant stay off of it - and need to go back on. Then you essentially have proven that you arent able to stay off. So they arent going to give you the path to stay off because you've shown you cant. So therefore your path going forward is to pass while being on.

Dollars and time for both of them are pretty onerous. Expect 8-12 months on pathway 1 and 5-8K. But again, I would let the actual docs chime in as to whether you will be forced down pathway 2 because of you briefly going back on.
 
learnin2fly said:
My confusion then comes from this, the entry point is "is ON anti-depressant", which I'm not. But for the sake of the argument, lets continue on the top row, I discontinued, and AME notes in block 60, after 60 days with favorable rpeort I can reapply for "regular issuance".

How much in $$$ and time is it to go through either of the paths?
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You were on once, then went off. You elected to go back on; that’s recurrent disease until proven otherwise.

For a better idea of what’s going to be required, look at the initial certification worksheet.


Figure close to a year or more and a few thousand or more dollars for a class 3 medical.

Or, if you have a valid DL and you and your treating physician consider your condition to be acceptable for recreational flying, bypass all of the above by going Sport Pilot which doesn’t require an FAA medical. If you choose to try for an FAA medical and for whatever reason it ends up denied, Sport Pilot is no longer a route you can take.
 
Just in case it hasn't been suggested yet, I think you should consider Sport Pilot. ;)

Once you have your Sport certificate, you can fly for a while and decide if you need to go on and get a Private. Nothing wasted; all your Sport training will count toward Private. Many pilots find that the limitations of Sport (daytime VFR only, no more than one passenger, aircraft limited to Light Sport category) aren't really that limiting at all, and you'll be able to fly anywhere in the US and the Bahamas. You just might decide that the Sport ticket is all you really need and it's not worth spending all the time and money for an FAA medical.

Plus, in a year or two it's likely that the FAA will broaden the definition of "Light Sport" to allow larger planes, like Cessna 172s and Piper Cherokees, under a program called MOSAIC. The new rule is in the review process right now.

OTOH, it's possible that you might fly for a while and decide it's not for you. It happens. In that case, it'd be better if you hadn't wasted time and money on a medical, right?
 
The difficulty is that you have had recurrent disease. You only get "reactive depression/anxiety" once in your life. On two separate occasions a licensed doc has though you were symptomatic AND needed treatement.

FAA denies 100% of "recurrent disease untreated and unmonitored" and so Decision path 1 will not work for you..
I'd get to a board cerfied psychiatrist while you are still no meds and there's something to treat (SO THE PSYCHIATRIST CAN afford to see you) and get his thoughts. Most commonly after two episodes you might actually be a warmer, more vibrant person on a microdose of one of the SSRIs....and the time to relapse will triple, too.
 
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bbchien said:
I'd get to a board cerfied psychiatrist whie you are still no meds and there's something to treat (SO THE PSYCHIATRIST CAN afford to see you) and get his thoughts. most comonly after two epidsoes you might actually be a warmer, more vibrant person on a microdose of one of the SSRIs....and the time to relapse will triple, too.
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Thanks for the reply @bbchien, is my case impossible to get a class 1 medical?
 
learnin2fly said:
Thanks for the reply @bbchien, is my case impossible to get a class 1 medical?
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not sure why you are jumping to conclusions. There has never been mention of the ssri pathways being eliminated from any class of medicals. Nor did the good doc say anything along those lines, nor the SSRI document from the FAA. You have to go through the process to get a medical - regardless of class 1, 2, or 3. And he is suggesting that you go to see a board certified psych doc to actual diagnose you and prescrive a microdose of one of the "approved" ssris, so that you can go through pathway II.
 
Also when these topics comes up, I feel like there is a bit of “get there itis” from those asking.

I understand the poster have wishes and goals. However, life’s not fair. You can’t always get what you want. It is also not all fun, games and candy to get your ticket. I know a few people who went from rating to rating then decides it wasn’t for them and stopped when they are fully licensed.

Going with the sport pilot option is perfectly viable for trying it out. You might find you like it or you might find you are so tense up you don’t actually enjoy it. Remember there are actual radio recording of both first time students landing after their CFI had a medical issue, and people deem ready to solo who freak out in the circuit and had to be talked down and everything in between.

When I see people say they are on meds and they really want to be a pilot. I also think are they saying that as a symptom of a disease? Sorry, but I have known folks with problems who fixated on how something will fix that feeling inside them and it never seem to be true.

I don’t know you from Joe blow, so you might be perfectly fine. However as noted you had been prescribed more than once. Beyond the regulatory issues maybe it is also good to consider if this is actually something good for you. The process and stress of going through the price to get the medical might be too much. When you are in the plane and you find it wasn’t what you hoped for will that be ok? Lots to consider.

Final note. I have observed that those with real mental issues rarely can be dissuaded from a course of action. They are so convinced they are right and the world is against them. And that’s why I wrote all this stuff above.
 
learnin2fly said:
Thanks for the reply @bbchien, is my case impossible to get a class 1 medical?
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You will find that quite frequently on this board, thoughts go unfinished. I believe the important part of Bruce's post was that you will not be certifiable if "untreated and unmonitored." However, there is a potential path to certification if you are successfully treated with an FAA-acceptable SSRI, and your doctors and the FAA agree that you can safely fly. That's the difference between "you don't have the disease, so you can fly," and "you have the disease, but it's well treated, so you can fly."
 
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You can absolutely get a first class medical but you will have to fulfill and have favorable reports from the HIMS psychiatrist and HIMS ame.
 
TCABM said:
You were on once, then went off. You elected to go back on; that’s recurrent disease until proven otherwise.

For a better idea of what’s going to be required, look at the initial certification worksheet.


Figure close to a year or more and a few thousand or more dollars for a class 3 medical.

Or, if you have a valid DL and you and your treating physician consider your condition to be acceptable for recreational flying, bypass all of the above by going Sport Pilot which doesn’t require an FAA medical. If you choose to try for an FAA medical and for whatever reason it ends up denied, Sport Pilot is no longer a route you can take.
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This is exactly the scenario I fell into. My local AME deferred my exam to the FAA since I am on an SSRI. I received a letter 4 months later outlining what documentation the FAA wanted, giving me 90 days to do so. I also had to find an HIMS AME (since the ssri is regarded as a drug dependency) and I finally found one in another state. I brought all of the requested documentation (from 3 doctors) to the HIMS AME except to 2 items I was unable to get. He informed me that I also had to get documentation from a psychiatrist and a neurophysiologist. He provided me with contact information for those in my area. I contacted the specialists and found their combined cost would be $5,000 to $10,000, so I was unable to complete the FAA request. In short, the FAA sent another letter indicating my application has been denied when my 90 days ran out. So the sport pilot route is not available to me. It would have been nice to have known all of this beforehand.
 
Calvin W said:
It would have been nice to have known all of this beforehand.
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Yes, it would.

It would be good for AMEs to explain this when you contact them, and it would also help if the FAA put a notification on the medical form: "Be advised that a denied medical will eliminate the option to fly as a Sport Pilot with only a driver's license."

But neither is likely to happen.

You can still fly gliders, though, even motor gliders.
 
…most of the AMEs don’t know/understand this.

But it’s here in post 13…
 
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