Anyone taken SSRI decision path 1 recently?

I am looking at FAA's decision path 1 (link below). I have discontinued my use of the SSRI but have to wait the 2 months out. While waiting, I want to be sure I have all the paperwork needed.

Anyone taken this route recently and got a successful medical? How involved or cumbersome was the process? What paperwork did you need? And how much time did it take for the various stages with FAA?

https://www.faa.gov/about/office_org/headquarters_offices/avs/offices/aam/ame/guide/media/SSRI Decision Path - I.pdf


please update on your process
Thank you!
 
I am looking at FAA's decision path 1 (link below). I have discontinued my use of the SSRI but have to wait the 2 months out. While waiting, I want to be sure I have all the paperwork needed.

Anyone taken this route recently and got a successful medical? How involved or cumbersome was the process? What paperwork did you need? And how much time did it take for the various stages with FAA?

https://www.faa.gov/about/office_org/headquarters_offices/avs/offices/aam/ame/guide/media/SSRI Decision Path - I.pdf

Thank you!
I am in the same boat, about to submit paperwork after coming off them for 60 days, how is yours coming?
I am looking at FAA's decision path 1 (link below). I have discontinued my use of the SSRI but have to wait the 2 months out. While waiting, I want to be sure I have all the paperwork needed.

Anyone taken this route recently and got a successful medical? How involved or cumbersome was the process? What paperwork did you need? And how much time did it take for the various stages with FAA?

https://www.faa.gov/about/office_org/headquarters_offices/avs/offices/aam/ame/guide/media/SSRI Decision Path - I.pdf

Thank you!
Did you have to notify anyone other than your doctor that you were going to be off the medication? what other paperwork are you referring to? I am doing the same but have only told my prescribing doctor that I am going off the medication. any advice would be helpful. thank.s
 
Short question first: Can a Basicmed pilot fly and take an SSRI (Fluoxetine) without all the BS? Anyone know the answer for sure? Having read the above discussion on "decision 1 and HIMS", not sure why anyone would want to open a can of worms if there is not an underlying diagnosis. Which would be this pilot in questions case. No diagnosis of any underlying problem. Tried the med years ago from a family doc and discovered more patience, hence less frustration.
There IS an underlying diagnosis for the SSRI. People love trying this one...
 
There IS an underlying diagnosis for the SSRI. People love trying this one...
...and it never works. Same dance the young attorneys do, who pleaded ADD to get Ritalin for 1st semester exams...."But I was never diagnosed".

"Hey Rocky, Watch me pull a rabbit out of my hat"
"Again? But that trick NEVER works...."

For onetime-in-one's-life reactive depression, it will. But that's a diagnosis. "I was never diagnosed, and given an SSRI?"--->doc goes before Board of Medicine and gets his license suspended.
 
rocky-by-images-onset-freedomdotcom.jpg
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Well, I'm getting close.
 
...and it never works. Same dance the young attorneys do, who pleaded ADD to get Ritalin for 1st semester exams...."But I was never diagnosed".

"Hey Rocky, Watch me pull a rabbit out of my hat"
"Again? But that trick NEVER works...."

For onetime-in-one's-life reactive depression, it will. But that's a diagnosis. "I was never diagnosed, and given an SSRI?"--->doc goes before Board of Medicine and gets his license suspended.
There are some docs that will put a diagnosis in the record or on insurance paperwork but never tell the patient. You have to be up front and ask the doc. About everything. Or you may find a nasty surprise in the future.
 
There are some docs that will put a diagnosis in the record or on insurance paperwork but never tell the patient. You have to be up front and ask the doc. About everything. Or you may find a nasty surprise in the future.

Yes. I suspect this happens a LOT. I'm one who found such a nasty surprise. I started getting junk mail about managing my diabetes. I never in my life been diagnosed with diabetes and do not have it. I have PRE-diabetes. When I confronted the doctor about how she was coding my visits she said the office was using the old system which has no code for pre-diabetes, you either have it or you don't so she codes that I have it so my insurance will pay for my a1c tests. I informed her that I want my records to accurately reflect the truth about me, even if I must pay out of pocket for tests and visits. She said she would get it corrected as they were transitioning to the new coding system but it was too late, the code had already leaked into third party databases and it's never going away.

Understand this: the clerks managing the electronic databases containing your health info will never take the trouble to chase down where the data went and correct it. I'm not getting a medical anymore but if I were I think I would need to prove to the FAA that I don't have diabetes against what the records say.

In my misguided doctor's defense she was trying to help me avoid full on diabetes by doing my a1c 4x per year (and lecturing me about it) but assumed I was like most of her other patients who apparently expect healthcare for little or no cost.
 
One would also have to inquire as to what point in the system your diagnosis codes (correct or not) got out to marketing people (or by junk mail do you just mean stuff sent by your own provider).

I had one of those goofy situations. A provider suggested I try one of the acid pills to see if I had reflux (I don't, been previously endoscoped, it's just likely post nasal drip from seasonal allergies). I try to get an express appointment for a colonoscopy (the gastros around here let you go straight to the procedure without an unnecessary preliminary appointment for the routine ones). I get turned down because of my "reflux." One, what the hell does my esophagus have to do with getting a colonoscopy and who said I had reflux. Sure enough, my idiot PCP put down prevacid on my profile which got sent along with the colonoscopy referral. I had rather unkind words with the office staff at the PCP over that one.
 
One would also have to inquire as to what point in the system your diagnosis codes (correct or not) got out to marketing people (or by junk mail do you just mean stuff sent by your own provider).

I had one of those goofy situations. A provider suggested I try one of the acid pills to see if I had reflux (I don't, been previously endoscoped, it's just likely post nasal drip from seasonal allergies). I try to get an express appointment for a colonoscopy (the gastros around here let you go straight to the procedure without an unnecessary preliminary appointment for the routine ones). I get turned down because of my "reflux." One, what the hell does my esophagus have to do with getting a colonoscopy and who said I had reflux. Sure enough, my idiot PCP put down prevacid on my profile which got sent along with the colonoscopy referral. I had rather unkind words with the office staff at the PCP over that one.

Exactly... I think this sort of thing is probably rampant. Most people are probably unaware of the mistakes in their records until it affects them such as what happened to you. I do not see many legal protections either to give us recourse to fix this kind of thing.

The junk mail is from third party contractors to my insurance company. I do not think it has gotten out into the general marketing world. But even if the doctor corrects the diagnosis with the insurance company, getting the insurance company to go on down the pipe and correct it with their subcontractors (for lack of a better word) is almost impossible.
 
...and there are some would be pilots who need meds, throw their meds away and say, "I'm fine!".
Yes, I agree.

Most docs take the time and talk with the patient, some don't. The one my dad used (that's another story) booked elderly patients on the order of 40-50 per day and spent but one or two minutes with them. Part of that is the low Medicare reimbursement rate.

I amd NOT blaming all docs - most are good - but unless a patient stays on top of things they may well find a nasty surprise later on. I have seen the result first-hand. I have also had very good docs that take the time....
 
Any update from the original posters or anyone else who has gone through Path 1 recently? Trying to determine the expected timeline for FAA review once the 60 days off meds has been completed.
 
The key here is that you cannot have any underlying diagnosis with a higher propensity to recur. Recurrent Major depression, Dysthymia, Chronic anxiety, are all situations where FAA does not want to certify you except on the SSRI protocol. The first of the list has a 50% recurrence rate in 4 years.

They will want to review your entire record to assure themselves that you do not have these items, and there are others. Unfortuanately most Family practitioner notes don't contain enough info to make that determination....and you end up need the testimony of a psychiatrist.

If you have a single episode and they can tell that it is not one of these three, then they use a "time yardstick", e.g
Cases on the med for over 2 years-->family doc's notes.
Cases more than 2 years on the med--->needs psychiatrist.
Cases more than 4-5 years--->HIMS psychiatrist.

They are very caution since Andreas Lubitz and the Germanwings A321 Suicide. Can you blame them?

(One of 4 petitioners, for the SSRI protocol). B

Hello Dr. Bruce and All,

I have found this thread very helpful and I hope someone will reply. I'm a student pilot going for 3rd Class. I was on Lexapro for 2.3 years for general anxiety for the pressures of life: Kids moving away; new wife; stressful job. Didn't really need it, but doc recommended it. I stopped 60 days ago and didn't even notice a change. I will have my PCP write up the situation. What words can I ask him to use that might clarify the situation best for the FAA? I know I'm right on the 2 year cusp. Any advice is welcome! Thanks, Doug V from MA
 
Hello Dr. Bruce and All,

I have found this thread very helpful and I hope someone will reply. I'm a student pilot going for 3rd Class. I was on Lexapro for 2.3 years for general anxiety for the pressures of life: Kids moving away; new wife; stressful job. Didn't really need it, but doc recommended it. I stopped 60 days ago and didn't even notice a change. I will have my PCP write up the situation. What words can I ask him to use that might clarify the situation best for the FAA? I know I'm right on the 2 year cusp. Any advice is welcome! Thanks, Doug V from MA
Similar situation regarding not really needing it. Dr suggested I take it when my job halted during covid. I’ve been on a small dosage for 6 mos and am considering stopping it as work has picked up again.
My Question is if it would be quicker to get the cert if I just stayed on it longer or should I stop and wait the 60 days? I don’t want to keep burning money in lessons if I can’t solo yet. Frustrating process for something that has had little to no effect on Me.
 
Hello Dr. Bruce and All,

I have found this thread very helpful and I hope someone will reply. I'm a student pilot going for 3rd Class. I was on Lexapro for 2.3 years for general anxiety for the pressures of life: Kids moving away; new wife; stressful job. Didn't really need it, but doc recommended it. I stopped 60 days ago and didn't even notice a change. I will have my PCP write up the situation. What words can I ask him to use that might clarify the situation best for the FAA? I know I'm right on the 2 year cusp. Any advice is welcome! Thanks, Doug V from MA
Doug, the FAA will give no credence to the PCP if you have been on for more than 2 years and in some cases if on onverf a year. You are going to need a board certified psychitrist's take on it. Get referred to one (which is now tough becuase the psychiatrist can no longer bill "Medication adjustment"....). You may have to pay for a forensickpsychiatrist's full detailed life history and write up, characterization compelte with al lthe bellss and whistles to allow an assesmsent of recurrence risk.

Sadly many PCPs "just don't know when to stop".

B
 
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