Short term use of amytriptiline

A

Anon

Guest
About 9 years ago when i was in real estate i mentioned to my doc that occasionaly i have trouble falling asleep due to an overactive brain thinking about all the things i had done that day and what needed to be done the next day, he prescribed me i think 25mg? I tried it on/off a month or two, i dont really remember but i stopped taking it cause it didnt do anything. I dont know what he may or may not have written in his notes, does this need to be included since it was so long ago? I just saw this med on another thread somewhere and wanted to ask.
Thx
 
No. Don't volunteer information! If I had to list every drug I've ever taken I'd need a lot of extra pages. They want to know about current medications.
 
9 years ago? I'm not sure I remember what I was doing 9 years ago.

The challenge here is that amytriptiline isn't used to treat sleep disorders, it's used to treat psychiatric disorders, specifically depression. You said it was prescribed to try to help you get your brain calmed down and it did nothing for that so you stopped. My read on this is the doctor guessed about your condition and had you try out a drug. The doctor guessed wrong, so the drug did nothing for you. But in order to have prescribed the medication, the doctor has to have created a diagnosis of at least minor depression.

My advice is to read the questions carefully and answer them truthfully. Question 17 asks about current medication, so you don't report it there. Question 18 asks a bunch of questions about history, some of which might be counter to your doctor's guess. I will note that 18m asks about mental disorders, including minor depression. That's not huge, if you were diagnosed with minor depression 9 years ago, have discontinued the medication without any relapse, then it is just noted and the AME will issue the medical.

I would do a consult with an AME prior to the official medical and ask about this specifically. You can report it and get certified.

Ummm...is this your first medical or is this an ommission that you want to try to recover from?
 
This is a first medical for ppl. Yes im wondering about question 18 here. I dont know what my md wrote in his notes for why prescribed or whether or not it will even come up. I havent been formerly diagnosed with it so my guess its no and since im not taking any meds now and havent in 9 years.
 
Also it was prescribed by my regular doctor, not a psychologist or psychiatrist.
 
So again, I would ask the AME for a consult. It will cost $100 or so, but you get to talk about your questions before you roll the dice...and you should never roll the dice with your medical.

Assuming the doctor's notes would say depression 9 years ago, treated for 2 months, has not reoccurred, they will merely note that and issue. But that is what the consult will tell you. You will need a statement from your doctor about what his notes were.

Or it may be something that you don't have to report at all. You need to get something from your doctor on what that was about.
 
Anon said:
About 9 years ago when i was in real estate i mentioned to my doc that occasionaly i have trouble falling asleep due to an overactive brain thinking about all the things i had done that day and what needed to be done the next day, he prescribed me i think 25mg? I tried it on/off a month or two, i dont really remember but i stopped taking it cause it didnt do anything. I dont know what he may or may not have written in his notes, does this need to be included since it was so long ago? I just saw this med on another thread somewhere and wanted to ask.
Thx
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Doc should have prescribed you exercise, tea, and in a pinch some scotch. Big pharmas going to big pharma I guess.


If you're just looking to be a VFR hobby pilot, I'd really look into a no medical LSA, unless you have a fair chunk of time and money to burn on this subject.

If you really want the medical, talk to this guy
http://www.aeromedicaldoc.com
 
I just called his office and they went back as far as their records go and the med doesnt show up in their electronic notes or paper notes.
 
Anon said:
I just called his office and they went back as far as their records go and the med doesnt show up in their electronic notes or paper notes.
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What about your insurance company?
 
Hey James, cant say for sure without calling multiple insurance companies who it even was. I think ill mention it to the me (while i have the bar code) and see what he says. It doesnt seem like it should be too much of an issue, and i think it was actually closer to 2006/07. Thanks
 
Anon said:
Hey James, cant say for sure without calling multiple insurance companies who it even was. I think ill mention it to the me (while i have the bar code) and see what he says. It doesnt seem like it should be too much of an issue, and i think it was actually closer to 2006/07. Thanks
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One point to keep in mind relative to doctor's and insurance files.... Just about everything, good and bad, is in a discoverable database somewhere. Which is why many on this forum do suggest the appropriate declaration of the event, condition, or medication to the FAA along with any/all required documentation to satisfy the FAA's curiosity.

If you bend an airplane or a person while exercising your pilot privileges, someone is going to go digging in those databases. If what they find items already declared, it's a yawn and the move on. If they find a "not allowed" item that wasn't declared, buzzards and red lights go off and your situation went from manageable to difficult, and now your certificate is at risk of being yanked...permanently.

This is why I disagree with what Paulie said in post #2 about "don't volunteer" the information.

I would reach out to Dr. Bruce Chien, www.aeromedicaldoc.com, hire him as your consultant and advocate, and find out what the prescribing doc needs to write up to explain what he prescribed and why. Even better if Dr. Bruce can provide a plain worded template for that letter.

Dr. Bruce has shared with us that if the correct and accurate information is bent into the shape that the FAA expects and accepts, then the chance of a positive outcome is increased.

So if you hire Dr. Bruce, get his assistance working with your PCP, get the right info in the right form from the PCP, then telling the FAA about the amitriptyline could become a much simpler event for the long term than if you ignored it or didn't hire Dr. Bruce.
 
So to preface this, and why i am asking, is for question 18 and relating to anxiety.

So heres an update, i contacted my most recent pcp. He insists that it was not him who prescribed the amitriptyline he only has a record of me telling him what i was taking. I think it was him but i could be wrong, this was during a very busy time in my life. If not him then have no idea who i would have seen or what insurance company it was.

He said he will write a letter to the effect of that i was seen for mild work related anxiety in 2012, an rx for xanax was declined and no further incidence has been presented. I'll have to see what his letter says to convey it more clearly.

So
a) should i have him proceed with the letter or could it do more harm than good?
b)My issue now is the Dr. Unknown. Do i coontinue searching for the needle?
C)Should i just disclose to AME with the letter and explaination and see if during a consult he will pass me or continue with looking for Dr.?

Yes i am a very analytical person. ;-)
 
Anon said:
This is a first medical for ppl. Yes im wondering about question 18 here. I dont know what my md wrote in his notes for why prescribed or whether or not it will even come up. I havent been formerly diagnosed with it so my guess its no and since im not taking any meds now and havent in 9 years.
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if its your first medical you're going to have to list every single drug you took back to being born - so make sure you identify that silver nitrate in your eyes at birth - and you must report all medical visits since birth. Thats the technical language of the form.

Before you fill out the form - make sure you know what your doctor has in your file for WHY he Rx'd that drug. You don't want to see a dx of something completely crazy in order to justify the Rx to an insurance company.

You MUST get a copy of that record immediately =- and the best way to do that is to give Bruce a call BEFORE you submit or schedule anything - I have a copy of every medical record going back to age 25 because I insist on them - but thats just me.

BTW - the FAA could care less what you think and what you say. They simply don't care - they only care what licensed physicians think who have documented a file and who are not related to you. Your explanation to the FAA is completely without merit. It might have some merit to a doc - but only in the sense that it is consistent with the medical facts in front of them.

As a litigator with 32 years of experience- everybody lies.
 
comanchepilot said:
if its your first medical you're going to have to list every single drug you took back to being born - so make sure you identify that silver nitrate in your eyes at birth - and you must report all medical visits since birth. Thats the technical language of the form..
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I'm pretty sure that's not true, Joe. Unless something has majorly changed in the last 3 years or so, you still only have to list meds you are currently taking, and medical visits over the last 3 years. There are a bunch of "have you ever in your life" questions about medical events and diagnoses that go back to birth, and the latter category (diagnoses) DOES include anything to do with mental illness, but the medical visits aren't (or weren't) among them, nor is there anything that says to list every drug you've ever taken. Depending on how thorough he is, of course the AME can ask lots of probing questions that might amount to the same thing, and if the airman lists a history of taking a psychoactive drug he probably will. But what you wrote there I'm very certain isn't true.

Unless of course you meant that part to be tongue-in-cheek... but that nuance was lost on me, and will surely be lost on a newbie.
 
As pointed out, make contact with and hire Dr. Bruce Chien to manage your case.

Not only once hired and properly authorized will he coach you and your doctors in what needs to be in the status letters (written one way, it’s good. Other way, major hand grenades and land mines), he can also guide you on how to proceed to dig up the required info.

Big tip... be humble, listen, and follow directions. The good doctor is highly in demand and has no time for folks that are arrogant, impatient, or think google searches outweigh his knowledge and experience.
 
azure said:
I'm pretty sure that's not true, Joe. Unless something has majorly changed in the last 3 years or so, you still only have to list meds you are currently taking, and medical visits over the last 3 years. There are a bunch of "have you ever in your life" questions about medical events and diagnoses that go back to birth, and the latter category (diagnoses) DOES include anything to do with mental illness, but the medical visits aren't (or weren't) among them, nor is there anything that says to list every drug you've ever taken. Depending on how thorough he is, of course the AME can ask lots of probing questions that might amount to the same thing, and if the airman lists a history of taking a psychoactive drug he probably will. But what you wrote there I'm very certain isn't true.

Unless of course you meant that part to be tongue-in-cheek... but that nuance was lost on me, and will surely be lost on a newbie.
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Tongue in cheek? you'd think so until you get to Question 18(x): HAVE YOU EVER IN YOUR LIFE BEEN DIAGNOSED WITH, HAD, OR DO YOU PRESENTLY HAVE ANY OF THE FOLLOWING? (x) other illness, disability or surgery." 'other illness?' Chicken pox at age 4. No FAA limiting language here.

Certainly chickenpox is a nothing burger, but imagine the guy who is Dx'd with childhood leukemia and is cured - its been 35 years. Is it remotely relevant today? Of course not. Would the FAA demand and insist and threaten to get medical records if you failed to disclose that and they somehow found out?

You're right about the Rx part though. And its not just Rx, but its drugs used today. So he needs to know what the medical record shows for why he was rx'd the drug named.

I have seen situations where a doc tells someone 'take this, it will eliminate these symptoms' while never telling the guy what the Dx was - so when the record gets pulled you have a big nasty Dx of ADHD or depression or some DSM-V ailment which is disqualifying and the guy never found out until he reports the drug, the FAA emergency revokes him or denies him. Thankfully thats rarer now - but - its still out there. . . .
 
Thank the heavens there is no 18(aa) “Stick up your ass”, otherwise me and a whole lotta others would have to answer yes to that.
 
comanchepilot said:
Tongue in cheek? you'd think so until you get to Question 18(x): HAVE YOU EVER IN YOUR LIFE BEEN DIAGNOSED WITH, HAD, OR DO YOU PRESENTLY HAVE ANY OF THE FOLLOWING? (x) other illness, disability or surgery." 'other illness?' Chicken pox at age 4. No FAA limiting language here.

Certainly chickenpox is a nothing burger, but imagine the guy who is Dx'd with childhood leukemia and is cured - its been 35 years. Is it remotely relevant today? Of course not. Would the FAA demand and insist and threaten to get medical records if you failed to disclose that and they somehow found out?

You're right about the Rx part though. And its not just Rx, but its drugs used today. So he needs to know what the medical record shows for why he was rx'd the drug named.
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He still doesn't have to list EVERY doctor visit. He just has to disclose illnesses he was diagnosed with. Even so, I SERIOUSLY doubt the FAA is concerned with chickenpox at age 4. Leukemia, of course, is a different matter entirely.

I had scarlet fever when I was 5. Totally forgot about it when filling out my first 8500-8. My conscience is clear and I'm pretty sure the FAA doesn't give a damn either.

It may seem like a meaningless distinction, but for doctor visits you're required to report, you have to give the name and contact info of the doctor, the purpose of the visit, and the date, all on the MedXPress. You DON'T have to do that if you were diagnosed with childhood leukemia 30 years ago. You just have to disclose the diagnosis, and of course the disposition, probably the treatment. Yeah, you'll probably need the records. That's something major. But you certainly don't have to list every clinic visit, every therapy session, on the 8500-8/MedXPress. Come on now.

For the OP's case, in the FAA's eyes, the dx that led to his getting rx'd with amitriptyline is a big deal. He'll need ample documentation and probably some further psych visits. But he doesn't need to worry about disclosing that he had the measles or chickenpox, and he definitely doesn't need to list the visits for them on MedXPress.
 
What really irks me is that there wasn't even any sort of medical evaluation, how can you one diagnose something especially a mental illness without having an evaluation to first ensure that there isn't something medically wrong before just writing a script and saying "next". Dx these days are getting ridiculous. I'll check with Walgreens and see if they have a record. Then possibly a call or email to dr. B
 
Anon said:
What really irks me is that there wasn't even any sort of medical evaluation, how can you one diagnose something especially a mental illness without having an evaluation to first ensure that there isn't something medically wrong before just writing a script and saying "next". Dx these days are getting ridiculous. I'll check with Walgreens and see if they have a record. Then possibly a call or email to dr. B
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Anon, I think this is a nonissue. I don't event think there is a place to put this on the FAA's form 8500-8.

Sorry I did not see this sooner. I don't come here very often because some think I'm here for "personal gain". Sigh.


:)
 
bbchien said:
Anon, I think this is a nonissue. I don't event think there is a place to put this on the FAA's form 8500-8.

Sorry I did not see this sooner. I don't come here very often because some think I'm here for "personal gain". Sigh.


:)
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what about the 'have you ever been diagnosed with mental illness?" question? Until you know what the doc put in the record. . . lots of times we have guys who 'don't know' what the doc said 20 years ago . . .

Anyway - if you say it's nothing - then thats good enough for me!
 
comanchepilot said:
what about the 'have you ever been diagnosed with mental illness?" question? Until you know what the doc put in the record. . . lots of times we have guys who 'don't know' what the doc said 20 years ago . . .

Anyway - if you say it's nothing - then thats good enough for me!
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That was also where my concern was not so much in the medication, as I'm not taking it or anything else but what my diag might have been. But if Dr.B says non issue I believe him.
 
bbchien said:
Anon, I think this is a nonissue. I don't event think there is a place to put this on the FAA's form 8500-8.

Sorry I did not see this sooner. I don't come here very often because some think I'm here for "personal gain". Sigh.


:)
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Thank you for your input Dr.B - I haven't read any of your posts as only here for gain, but if needed I'm happy to hire you to get this correct the first go. I've been trying to find all the info I can before wasting any of your time.
 
Maybe because of the length of time it was taken? I think the limit is 60 days or less.... but I'm still stuck on the diagnosis the doc put in the record, can't see how it wouldn't matter to the FAA.

If Bruce misread, I'm sure he'll correct himself... otherwise, you can take his answer to the bank!
 
bbchien said:
Anon, I think this is a nonissue. I don't event think there is a place to put this on the FAA's form 8500-8.

Sorry I did not see this sooner. I don't come here very often because some think I'm here for "personal gain". Sigh.


:)
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Hey, I say if your personal gain is getting pilots back in the air, screw what anyone else thinks ;)
 
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