Trazodone for insomnia and the FAA

[StillAwake]

My doctor has prescribed Trazodone (50mg) as part of our efforts to end my insomnia.

It appears the FAA does not accept this drug: https://www.leftseat.com/psychotropic-medications/ since it is sometimes used for depression.

But no mention of it here: https://www.faa.gov/about/office_org/headquarters_offices/avs/offices/aam/ame/guide/pharm/sleepaids/

I'm not flying for unrelated reasons and my Class III medical lapsed. At least six months until I fly, and considering going Basic Medical versus Class III.

Anyone with specific knowledge about Trazodone and the FAA have any thoughts? Thank you.

 

[Kenny Phillips]

I don't believe BasicMed gets you off the hook for any prohibited drugs.

 

[bflynn]

Under BasicMed, that issue is between the pilot and his doctor.

Pilots are still required to self evaluate before each flight and while FAA medical information is not binding, it's useful to consider.

 

[Half Fast]

I don't believe BasicMed gets you off the hook for any prohibited drugs.

Completely depends on whether a physician will sign the Basic Med form with him using the drug. The FAA doesn't even get a form that says he's taking it, and the signing physician has no obligations to the FAA regarding what they approve.

Of course, the FAA drug list is useful information that can be considered by the physician and the pilot.

 

[Kenny Phillips]

Completely depends on whether a physician will sign the Basic Med form with him using the drug. The FAA doesn't even get a form that says he's taking it, and the signing physician has no obligations to the FAA regarding what they approve.

Of course, the FAA drug list is useful information that can be considered by the physician and the pilot.

Is the FAA drug list "shall not issue medical" or "shall not fly"?

 

[Half Fast]

Is the FAA drug list "shall not issue medical" or "shall not fly"?

Well, the language is from the guide for AMEs and appears to be advisory. It says "should" and not "shall:"

​

For Basic, there's no AME involved and the AME guide is not a required document for physicians to use in doing a Basic Med approval.

Further down, there's this:

​

But again, this is a guide for AMEs and I don't think it would be considered mandatory for an airman, especially with the "should not" language, which doesn't sound prohibitive.

But I'd like to see
@Brad Z offer an opinion.

 

[bflynn]

Is the FAA drug list "shall not issue medical" or "shall not fly"?

The U.S. Federal Aviation Administration does not publish a list of “approved” medications for pilots. Nor do they publish a comprehensive list of drugs which are prohibited.

The pilot is required to self evaluate prior to flying. Other than the initial BasicMed certification, that is the only thing involved.

61.51 (b) Operations that do not require a medical certificate. For operations provided for in § 61.23(b) of this part, a person shall not act as pilot in command, or in any other capacity as a required pilot flight crewmember, while that person knows or has reason to know of any medical condition that would make the person unable to operate the aircraft in a safe manner.

AME standards are not referenced under BasicMed. A pilot may optionally reference them as a guide, but they are not required and not binding.

 

[idahoflier]

The decision you need to make is not whether BasicMed will work for you but whether or not you want to pursue a Third Class medical. If you get deferred and have to start the SI process, BasicMed AND Sport Pilot is off the table until you are successful in obtaining the SI.

This is from the FAA website:
"Medical conditions that chronically interfere with sleep are disqualifying regardless of whether a sleep aid is used or not. Examples may include primary sleep disorders (e.g., insomnia, sleep apnea) or psychological disorders (e.g., anxiety, depression)."

If you go through with a Third Class, make sure you thoroughly know and understand what's going to happen BEFORE you submit the form! Also make sure you see what your Dr. diagnosed and put in your medical records.

 

[Brad Z]

Well, the language is from the guide for AMEs and appears to be advisory. It says "should" and not "shall:"

View attachment 86378
​

For Basic, there's no AME involved and the AME guide is not a required document for physicians to use in doing a Basic Med approval.

Further down, there's this:

View attachment 86379
​

But again, this is a guide for AMEs and I don't think it would be considered mandatory for an airman, especially with the "should not" language, which doesn't sound prohibitive.

But I'd like to see
@Brad Z offer an opinion.

Well, the language is from the guide for AMEs and appears to be advisory. It says "should" and not "shall:"

View attachment 86378
​

For Basic, there's no AME involved and the AME guide is not a required document for physicians to use in doing a Basic Med approval.

Further down, there's this:

View attachment 86379
​

But again, this is a guide for AMEs and I don't think it would be considered mandatory for an airman, especially with the "should not" language, which doesn't sound prohibitive.

But I'd like to see
@Brad Z offer an opinion.

My personal opinion is that there is nothing in section 2307 of the statute, part 68, or 61.113(i) that references a requirement to heed the FAA's guidance to AMEs on pharmaceuticals. That said, the state-licensed physician signing the BasicMed checklist is required to discuss with you any potential of any medications you are taking to interfere with the safe operation of an aircraft or motor vehicle. The physician isn't required to reference the FAA's guidance to AMEs on pharmaceuticals, but the information and links are provided to the signing physician for his or her reference.* Ultimately it is up to his or her own clinical judgement to decide whether or not they are okay with you taking any particular medication.

If you're aware that you're taking a medication or class of medication that's on the FAA's list, it would be advisable to discuss this detail with the doctor. Under BasicMed, the FAA is shifting responsibility from it's own part 67 medical certification system to you. Don't abuse the privilege.



* The languange used on the checklist to state-licensed physicians states: "You should consider consulting available aeromedical resources on the flight hazards associated with medical conditions/medications, to include[...]"

 

[StillAwake]

OP here - thanks for the helpful info, everyone.

My Class III lapsed without incident. I'm not planning to fly until the insomnia is cured or well-controlled by lifestyle changes - the medication is an interim way to break the bad cycle and get started on good ones. I hope to avoid a CPAP, but, perhaps not.

It doesn't appear the Trazodone (50mg) would prevent a Basic Med later, assuming I'm off the medication for 90 days or more. Correct?

Does the use of the Trazodone (50mg) now prevent a Class III later, assuming I've been off the Trazodone for 90 days or more?

 

[Half Fast]

It doesn't appear the Trazodone (50mg) would prevent a Basic Med later, assuming I'm off the medication for 90 days or more. Correct?

AFAIK, you could be taking Trazodone and fly with Basic Med, if a physician would sign the Basic Med form. That wouldn't be wise, necessarily, but under Basic Med your health and your medications are between you and your doctor. The FAA is not involved.

Basic Med is not an FAA medical. It's an approved way for you to fly without an FAA medical.

 

[idahoflier]

Your situation requires professional advice. Seek guidance from a competent AME or reach out to AOPA. Don’t rely on a bunch of opinions from people posting to aviation forums...

 

[IK04]

Pretty sure that was the drug we took in combat to sleep after some missions that would "keep you up at night."

I never had that problem...

Oh, and we took Hydroxychloroquin, too...

 

[bbchien]

Does the use of the Trazodone (50mg) now prevent a Class III later, assuming I've been off the Trazodone for 90 days or more?

That would depend on the diagnosis! Example, if the cause of the need of trazodone was depression FAA would want to understand (1) is it gone (2) have you had it more than once, etc etc, as in likelihood it will recur. (3) how severe was it. If it were PTSD, they'd want to know the state of that diagnosis. (3) Excess alcohol....well that's a total 'nother kettle of fish. (4) If it were due to sleep apnea, they'd want you to get that treated. etc. etc.

 

[Francis Reyes]

That would depend on the diagnosis! Example, if the cause of the need of trazodone was depression FAA would want to understand (1) is it gone (2) have you had it more than once, etc etc, as in likelihood it will recur. (3) how severe was it. If it were PTSD, they'd want to know the state of that diagnosis. (3) Excess alcohol....well that's a total 'nother kettle of fish. (4) If it were due to sleep apnea, they'd want you to get that treated. etc. etc.

I am now in this boat. What if the diagnosis was for insomnia as the original poster asked?

 

[bbchien]

The diagnosis of simple “Insomnia” is a DSM 5 Category diagnosis that encompasses many potential psychiatry diagnoses. FAA wants to know with much more precision!

 

[Gatorjesse]

My doctor has prescribed Trazodone (50mg) as part of our efforts to end my insomnia.

It appears the FAA does not accept this drug: https://www.leftseat.com/psychotropic-medications/ since it is sometimes used for depression.

But no mention of it here: https://www.faa.gov/about/office_org/headquarters_offices/avs/offices/aam/ame/guide/pharm/sleepaids/

I'm not flying for unrelated reasons and my Class III medical lapsed. At least six months until I fly, and considering going Basic Medical versus Class III.

Anyone with specific knowledge about Trazodone and the FAA have any thoughts? Thank you.

I just went through the exact same thing you will if you try and get your third class back. I had the same dosage too. Immediately deferred by AME and had to show three months of pharmacy records to prove I was not taking it anymore. Took about a year of back and forth and no flying.