Question about SI Process for SSRI use

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rmsas

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rmsas
I'm currently applying for Class 3 Medical and my application got deferred due to SSRI use (Escitalopram 10mg for depression for 7 months). My AME informed me that I need to get a report from my Psychiatrist to send to the FAA and highly recommended I seek out a HIMs Psychiatrist for that report, but I was curious if anyone had success with getting a report from their prescribing Psychiatrist instead of having to reach out to a HIMs Psychiatrist? Just some additional details... this is my first episode/diagnosis of any mental health disorder, and I've only taken this medication. Otherwise, I am healthy, and I see my psychiatrist once monthly since being prescribed back in Nov 2023.
 
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rmsas said:
I'm currently applying for Class 3 Medical and my application got deferred due to SSRI use (Escitalopram 10mg for depression for 7 months). My AME informed me that I need to get a report from my Psychiatrist to send to the FAA and highly recommended I seek out a HIMs Psychiatrist for that report, but I was curious if anyone had success with getting a report from their prescribing Psychiatrist instead of having to reach out to a HIMs Psychiatrist? Just some additional details... this is my first episode/diagnosis of any mental health disorder, and I've only taken this medication. Otherwise, I am healthy, and I see my psychiatrist once monthly since being prescribed back in Nov 2023.
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I'm in a similar situation, I got a deferral and I can pretty much guarantee they will require you to 1. get a HIMS AME, 2. have a HIMS psychologist evaluation, 3. have a HIMS neuropsychologist evaluation, 4. get the full medical records and notes from your treating physician, as well as have you provide a personal statement on your use of SSRI's and general comments. If there are any notes from your treating physician of alcohol abuse/dependence during the intake and prescription process, don't be surprised if the FAA then requires you to conduct another HIMS evaluation for the substance as well. I'm over 15 months in and likely looking at another 12-18 before a final issuance decision. It's a whip, good luck!
 
I was in a similar situation - I used Escitalopram for about a little less than a year to help me through some situational stress and ended the medication with the help of my prescribing doctor. The process felt very complicated when I started and truthfully, it was, but I did end up getting my Class 3 medical eventually. It took working with a HIMS AME, getting a psych eval from a psychiatrist, getting notes from my prescribing doctor stating my well-being, and waiting more than a year to get it. The FAA is extremely backlogged. If you can afford it, I recommend using an advocacy service like Aviation Medicine Advisory Services (AMAS) or Left Seat to help navigate the process. I used AMAS and they helped a ton. They offer a one-time consult via email or phone if you didn't want to use the full retained services. You could also call AOPA Medical line if you're a member and they can help you navigate (though my vote is AMAS's paid consult is a better experience if you're budget conscious, having used both.)

Ultimately, my read (not official) is that for non-recurrent situations, I think the FAA has a larger issue with the underlying diagnoses than the usage of Escitalopram. The FAA just released new guidance this month for uncomplicated anxiety and depression - which could be very helpful for you, perhaps. (I am actually in shock that they revised this. Makes me very happy at the progress, as I thought this would never come, but I digress...)

See the news here: https://www.avweb.com/aviation-news/faa-amends-mental-health-evaluation-criteria-for-pilots/

And the official docs here: https://www.faa.gov/ame_guide/media/Anxiety_Depression_Disposition_Table.pdf

I would check those docs out and consider contacting a confidential advocacy service like I listed if you meet the criteria listed in that official FAA doc I linked.

All in all - if your case is as straightforward as it sounds by your description, I think you'll be fine. You will need to be EXTREMELY patient and be prepared to go gathering lots of documents, but hopefully you fall under the new rules so it's quick and easy. Good luck and happy flying!
 
John21 said:
I was in a similar situation - I used Escitalopram for about a little less than a year to help me through some situational stress and ended the medication with the help of my prescribing doctor. The process felt very complicated when I started and truthfully, it was, but I did end up getting my Class 3 medical eventually. It took working with a HIMS AME, getting a psych eval from a psychiatrist, getting notes from my prescribing doctor stating my well-being, and waiting more than a year to get it. The FAA is extremely backlogged. If you can afford it, I recommend using an advocacy service like Aviation Medicine Advisory Services (AMAS) or Left Seat to help navigate the process. I used AMAS and they helped a ton. They offer a one-time consult via email or phone if you didn't want to use the full retained services. You could also call AOPA Medical line if you're a member and they can help you navigate (though my vote is AMAS's paid consult is a better experience if you're budget conscious, having used both.)

Ultimately, my read (not official) is that for non-recurrent situations, I think the FAA has a larger issue with the underlying diagnoses than the usage of Escitalopram. The FAA just released new guidance this month for uncomplicated anxiety and depression - which could be very helpful for you, perhaps. (I am actually in shock that they revised this. Makes me very happy at the progress, as I thought this would never come, but I digress...)

See the news here: https://www.avweb.com/aviation-news/faa-amends-mental-health-evaluation-criteria-for-pilots/

And the official docs here: https://www.faa.gov/ame_guide/media/Anxiety_Depression_Disposition_Table.pdf

I would check those docs out and consider contacting a confidential advocacy service like I listed if you meet the criteria listed in that official FAA doc I linked.

All in all - if your case is as straightforward as it sounds by your description, I think you'll be fine. You will need to be EXTREMELY patient and be prepared to go gathering lots of documents, but hopefully you fall under the new rules so it's quick and easy. Good luck and happy flying!
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Many thanks for the feedback! I'll look into the AMAS services. My HIMS AME has been very helpful, but doesn't hurt to get some additional insights.

Thanks again!
 
I did it, but I was off the meds. If you choose to discontinue the medication I think you qualify for situational depression because it was only one occurrence of a duration less than 2 years. All I did was send the requested documents to the FAA and I was approved about 9 months later. Here is the link to the thread for my situation. Make sure your doctor includes all the points that are required, which were are listed in the thread by bbchien. https://www.pilotsofamerica.com/com...and-incorrect-condition-listed-by-ame.143669/
 
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