SSRI amnesty, no longer on SSRIs

[Unregistered]

I've read the several helpful posts by Dr. Bruce and others on the FAA's new SSRI policy. Thanks to all of you for taking time to contribute on this subject. I'm hoping Bruce will chime in on this question, which I didn't see answered anywhere else.

I had taken an SSRI (Zoloft) for minor situational depression before getting my first medical in 2001, and I'd discontinued the medication about 90 days before the application. That usage was disclosed on that application, and I received a SI certificate with the expected warning to self-ground if symptoms reoccurred. The SI was removed 12 months later. I mention this part only to note the prior history that's in my file.

Several years later, while holding a second class medical certificate, I had a reoccurrence of the depression--again, mild and situational--for which I took Prozac for about 18 months. I then came off the medication, and have been off since last December, without any symptoms.

My current medical certificate expires this December.

Questions:

1. To take advantage of the amnesty provision, do I need to see my AME to make a new application? Or do I just need to send the current certificate with the confessional letter and required documentation to the FAA? Really what I'm asking is, what's the *fastest* route to reissuance?

2. What documentation do I need to provide, since I'm not currently in treatment and haven't been for more than 180 days? Is a letter from the treating psychiatrist sufficient, or do I need to schedule any tests? (Just being cognizant of the approaching deadline--if tests are needed I want to get them planned.)

3. Will the fact that this was a second episode of depression--even though, like the first, it was resolved and I'm symptom-free--affect the likelihood of a successful reissuance of my medical certificate?

4. About how long should I expect the process to take, once the application or letter are sent to the FAA?

Thanks again to Dr. Bruce and anyone else who responds.

 

[bbchien]

I've read the several helpful posts by Dr. Bruce and others on the FAA's new SSRI policy. Thanks to all of you for taking time to contribute on this subject. I'm hoping Bruce will chime in on this question, which I didn't see answered anywhere else.

I had taken an SSRI (Zoloft) for minor situational depression before getting my first medical in 2001, and I'd discontinued the medication about 90 days before the application. That usage was disclosed on that application, and I received a SI certificate with the expected warning to self-ground if symptoms reoccurred. The SI was removed 12 months later. I mention this part only to note the prior history that's in my file.

Several years later, while holding a second class medical certificate, I had a reoccurrence of the depression--again, mild and situational--for which I took Prozac for about 18 months. I then came off the medication, and have been off since last December, without any symptoms.

My current medical certificate expires this December.

Questions:

1. To take advantage of the amnesty provision, do I need to see my AME to make a new application? Or do I just need to send the current certificate with the confessional letter and required documentation to the FAA? Really what I'm asking is, what's the *fastest* route to reissuance?

You need to notify FAA of your falling off onto the SSRI, by certified mail, before Sept 30. They will want your medical certificate back, but this portects you PILOT certificate.

2. What documentation do I need to provide, since I'm not currently in treatment and haven't been for more than 180 days? Is a letter from the treating psychiatrist sufficient, or do I need to schedule any tests? (Just being cognizant of the approaching deadline--if tests are needed I want to get them planned.)

See the attachment, page 14, it's all there. (I've posted if before)

3. Will the fact that this was a second episode of depression--even though, like the first, it was resolved and I'm symptom-free--affect the likelihood of a successful reissuance of my medical certificate?

Unlikely, if your psych diagnoses simple recurrent unipolar depression. Like I say, it's on page 14.

4. About how long should I expect the process to take, once the application or letter are sent to the FAA?

About 60 days. The point of this is that they will let you stay on your SSRI at a low dose ALL the time, so that you don't have recurrences.

Thanks again to Dr. Bruce and anyone else who responds.

 

[Unregistered]

Thanks, Dr. Bruce. So if I understand your response and the PDF correctly, the required testing is the same whether or not an airman is currently taking an SSRI? In a different thread I thought you'd said that only a status letter from the psych might be required unless she thought additional testing was was warranted.

And you raised another interesting point...if I was to go through this process and later needed to go back on Prozac, would I then need to surrender my certificate again for 12 months to show stability on the med before regaining my certificate? Or does the first process basically eliminate that second wait? (I'm assuming of course that the second diagnosis and medication is the same as before.) I hope that question makes sense.

 

[bbchien]

Thanks, Dr. Bruce. So if I understand your response and the PDF correctly, the required testing is the same whether or not an airman is currently taking an SSRI? In a different thread I thought you'd said that only a status letter from the psych might be required unless she thought additional testing was was warranted.

I don't know from where you got that. You dont' have a single episode of depression. You have chronic recurrent depression. We wrote the SI for chroinc recurrent depression.

For a single reactive depression a status letter from the psych might do it, but you have demonstrated (likely ) a different illness, for which the SI was designed. I think you are under the impression that all depression is the same. Not true

And you raised another interesting point...if I was to go through this process and later needed to go back on Prozac, would I then need to surrender my certificate again for 12 months to show stability on the med before regaining my certificate? Or does the first process basically eliminate that second wait? (I'm assuming of course that the second diagnosis and medication is the same as before.) I hope that question makes sense.

You still don't get it. Even between episodes of depression, you have the same illness. IT's all ONE. It's just that in between you are indistinguishable from the normal. What sets you apart and gives you the kind of depression for which the SI was written, is you're having recurrent episodes a few years apart.

Ask your psych if he/she agrees. If he does, you'd be better off on the SSRI, low dose, all the time. Your relapses would be more distant.

Did I do an OK job explaining? IN BETWEEN EPISODES you are still having the same illness, you're just not distinguishable from the norm. But we think we RECOGNIZE that you would be better on the SSRI ALL THE TIME, and would have fewer relapses.

If you have the type of depression we wrote, you would have to have a one year period of stability on low dose SSRI, once, until your very distant next relapse, MADE to be very distant by the continued presence of the low dose SSRI.

 

[Unregistered]

Dr. Bruce,

Yes, that's helpful and more clear. I had not drawn that distinction.

Last question, just to clarify this:

you would have to have a one year period of stability on low dose SSRI, once....

I assume that one year period would have to be AFTER the initial disclosure to the FAA, and there's no "credit" for the prior 18-month period of stability that occurred pre-disclosure?

What I'm getting at is, if I did go back on Prozac at some point after coming clean with the FAA--assuming same low dose, same treating psychiatrist, same diagnosis, etc. as before--am I still grounded for 12 months to assess stability?

Thanks again.