Lindberg
Final Approach
Are you taking about SSRIs? Because the ones that are permissable are actually referenced in the earlier-linked document. There are four. So it's not really a case of being allowed to operate while taking drugs on that list. It's a case of the list including a class of drug but excluding a limited number of specifically named drugs in that class.
This is where you start to lose me in your argument. For certain classes drugs or medications, the FAA clearly states that even under the oversight of an AME and regulatory review by the FAA, those medications are wholly incompatible with flying.
I do not believe either BasicMed or DL medicals invalidates that regulatory guidance. It simply shifts the burden of proving fitness to fly from the FAA to the airman for self-certification.
dbahn
Pattern Altitude
Yes. But the drugs on that "Do Not Issue - Do Not Fly list" also includes diabetic meds, smoking cessation aids, steroids, and some others that have to be reviewed by the FAA but can then be determined to be acceptable.
Let me stop here and just remind the OP and others that we are talking about our various opinions based on interpretation of written regulations and advisories. The only opinion that counts is that of the Chief Legal Council - if he has rendered an opinion on this particular situation. I don't know that he has, but welcome that answer if anyone does know.
For completeness, here's the text from the beginning of that list, with bold added by me:
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Fat harris
Guest
I would be interested in his opinion on clozapine vraylar and lumictal taken only at night in low doses in regards to sports pilot all of which are extremely effective for bipolar
Clozapine and Vraylar are both anti-psychotics and lumictal is an anti-seizure medication.
Based on that information, I cannot see a reasonable person self-certifying they are fit to fly with any of those medications on board for any reason, whether on-label or off-label.
Based on that information, I cannot see a reasonable person self-certifying they are fit to fly with any of those medications on board for any reason, whether on-label or off-label.
dbahn
Pattern Altitude
When it comes to Chief Counsel opinions it's best to search for one that's already been published rather than to contact the Chief Counsel office and ask for one. You don't want to poke the bear and get an opinion that could adversely affect you and many other pilots. I'm hoping that someone reading this thread will recall and reference a related one that would be useful to establish guidance on the issue. As I said nearly 40 posts ago, I'm not sure how the issue is interpreted by the FAA. Personally, I would be VERY surprised if they held the lower category privileges to the same high standards used in an AME evaluation, but if I knew that for a fact I wouldn't be seeking an existing Chief Counsel opinion.
Keep in mind that some meds are permitted if they are discontinued for an adequate time before acting as PIC, but when you are taking them by necessity on a regular basis for a mental health issue the odds of getting FAA approval in that situation drop significantly.
dbahn
Pattern Altitude
Agree, but the question should always be addressed, "Does the person actually need the medication that's been prescribed?" I can tell you that from my experience as an M.D. there are a huge number of cases where that has not been the case, unfortunately.
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Fat harris
Guest
Fair enough. If that’s the case then I will taper off them. My mood swings where never longer that 15-20 minutes and I never had a manic episode so I guess time will tell if they are or are not needed.
bflynn
Final Approach
have they ever? I’m not worried, for multiplier reasons.
The FAA has studiously avoided making any kind of comment related to medical issues for sport. Even here, they don’t tell you which drugs you cannot fly with. You and your doctor are more informed about your situation than the FAA ever will be. They withhold their opinion because it doesn’t count.
I’m not qualified to answer that question in this specific instance, and as a lay person I have to assume the provider is qualified to prescribe the medications as part of a treatment plan.
I can’t assume the treatment plan is based on off-label usage and I certainly can’t be expected to understand any possible adverse interactions the medications may light off, which leaves me, as an airman, to respect the FAA’s expertise in recommending whether or not an airman should self certify their fitness to fly, whether that recommendation is directed to AMEs or not.
Lindberg
Final Approach
Antipsychotics and anti seizure medications are on this list. It's almost certain that FAA legal reviewed this, even though it's not an official opinion.
https://www.faa.gov/about/office_org/headquarters_offices/avs/offices/aam/ame/guide/pharm/dni_dnf/
Daleandee
Final Approach
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Dale Andee
Could your mood swings be labeled as one of these five?
https://pilotinstitute.com/aviation-hazardous-attitudes/
Is it your decision or you doctors decision for you to "taper off" your required medications? This is common side effect among people with cognitive issues i.e. they don't realize they are not in a position to evaluate their physical & mental state.
Talk to a CFI and be honest with them about your condition. Let them evaluate you through a few instructional flights to see how well you handle stress and multitasking. You might be surprised at what you learn.
You posted here asking a question that it seems you have already given to yourself the answer you want.
dbahn
Pattern Altitude
I'm not qualified either (and that's after four years of medical school, two years of surgical internship and residency, three years of orthopedic residency and a year of pediatric orthopedic fellowship, all prior to a career in group practice). But even as lay persons, we've seen countless examples of young pilot applicants having been "carelessly" (IMHO) placed on psychotropic medications for diagnoses that barely existed before the medications used to treat them were developed and promoted. You can hardly watch TV these days without thinking you might be missing out on one of the newest medications to treat whatever ailments you choose. Most all providers are qualified to prescribe the medications, just as surgeons are qualified to perform the operations, but there are a number of factors which go into choosing the right treatment, patient satisfaction being just one of them.
Still, it's clear to me that there's a huge difference in certifying a pilot for operations carrying hundreds of passengers in a Mach 0.9, 50 ton aircraft and a hobbyist flying around in his J3 Cub. To its credit, the FAA has not lumped those together for the purpose of medical certification, and in between those two extremes there is a mix of requirements that reflect the risks involved to passengers. I'm equally in favor of the leniency for the Sport Pilot as I am for the stringent requirements for the pilot with an ATP rating.
Having seen my bipolar ex drive us back from Montreal to Toronto before the relationship ended. I’d say the person suggesting consider what is wise, is a wise person.
The problem with bipolar is that the spectrum is large and some folks have associated conditions.
My own experience with said ex was she would try her darnest best to explain away her condition. I also recall her saying how she thinks the diagnosis was wrong and that she doesn’t need meds. Yet she self medicated and her mom was also unstable and died by suicide when she was a teen.
I think OP should get an assessment by a professional. However if OP is anything like my ex I doubt rational thinking would predominate the final decision. That’s just my thinking…
The problem with bipolar is that the spectrum is large and some folks have associated conditions.
My own experience with said ex was she would try her darnest best to explain away her condition. I also recall her saying how she thinks the diagnosis was wrong and that she doesn’t need meds. Yet she self medicated and her mom was also unstable and died by suicide when she was a teen.
I think OP should get an assessment by a professional. However if OP is anything like my ex I doubt rational thinking would predominate the final decision. That’s just my thinking…
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Fat harris
Guest
it would be my doctors choice I would not ask to do something he would not be comfortable with and to be honest I probably won’t ask to switch the meds and just hope the rules change. I understand you guys say that clozapine is not certified but I really don’t think it’s that extreme but I will listen to your opinion unless advices by a aviation lawyer otherwise. What about lithium? Would you say that is an option or would it be better for it to be Prozac? Like I said earlier my doctor says I was missed diagnosed and that since I never had a manic episode my condition is much more depressive that anything elts
I think what you’re missing is you have to self-certify your fitness to fly before every single flight. The question is how do you reliably determine that?
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Fat harris
Guest
I am a very self aware person and I think by objectively asking my self a set of questions I can for example did I get enough sleep last night did I eat a healthy breakfast have I experienced any mood swings or other symptoms in the last five years am I happy calm and alert I can determine my fitness to fly
Daleandee
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Dale Andee
Piloting a plane requires some extensive multitasking at times and in certain situations it cannot be be avoided. Even my simple VFR sport plane gets pretty busy at times and the ability to function while multitasking under stress is a quality that a pilot must possess. There are plenty of times when a pilot is "up there, wanting to be down here."
I'm not trying to squash your dream of flight but rather to keep you alive. I'm not saying you cannot do this but I am saying that you have some serious things to be considered. Perhaps flying with a CFI will help you determine how well you handle stress in a plane (my instructor certainly knew how to make me sweat). You may even consider an ultralight aircraft to begin with and grow from there. Here's just one example ...
https://www.kolbaircraft.com/firefly.htm
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Fat harris
Guest
Piloting a plane requires some extensive multitasking at times and in certain situations it cannot be be avoided. Even my simple VFR sport plane get pretty busy at times and the ability to function while multitasking under stress is a quality that a pilot must possess. There are plenty of times when a pilot is "up there, wanting to be down here."
I'm not trying to squash your dream of flight but rather to keep you alive. I'm not saying you cannot do this but I am saying that you have some serious things to be considered. Perhaps flying with a CFI will help you determine how well you handle stress in a plane (my instructor certainly knew how to make me sweat). You may even consider an ultralight aircraft to begin with and grow from there. Here's just one example ...
https://www.kolbaircraft.com/firefly.htm
not a bad idea I will definitely also do at least twice the hours required
Mason
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Mase
Take it one step at a time.
dbahn
Pattern Altitude
Yes, but I think the point here as well is that when you self certify you do so by the regulations, specifically referring to 61.53, both (a) and (b).
For example, you are newly diagnosed by biopsy of having asymptomatic prostate cancer. You NOW have reason to know that you would not meet the qualifications for the Class 2 medical certificate that you already hold, so you self-ground as a commercial pilot until you do meet the qualifications, and you report it on your next exam. During that time you also know that you are safe to operate under Sport Pilot, because the risk of pilot incapacitation is extremely low (near zero) if there are no other symptoms of the disease.
Right now there is a high percentage of older pilots who have prostate cancer, don't know they have it, and will continue to fly for many, many years until it's discovered. If you are over 50, operating with an AME assisted medical, and you don't agree with the above opinion, please schedule a PSA test and a urology appointment as soon as possible so you can self ground until you can prove you are safe to fly.
So how do you interpret 14 CFR 61.53(c)?
(c) Operations requiring a medical certificate or a U.S. driver's license. For operations provided for in § 61.23(c), a person must meet the provisions of -
(1) Paragraph (a) of this section if that person holds a medical certificate issued under part 67 of this chapter and does not hold a U.S. driver's license.
(2) Paragraph (b) of this section if that person holds a U.S. driver's license.
dbahn
Pattern Altitude
So I interpret that to mean that as long as I hold a U.S. driver's license I can operate by only meeting the requirements of paragraph (b). But if I hold only a medical certification under part 67 but do not hold a U.S. driver's license then I must meet the requirements of paragraph (a). In other words, if you hold both a medical certificate and a driver's license you can legally fly Light Sport even if you know or have reason to know that you can't meet the requirements for a medical certificate but can operate safely.
From 61.53 (c), I've bolded what I believe is all that is relevant to this issue:
I'll be the first to admit I might be missing something in all of those "either/or" statements but it appears that as long as I hold a U.S. driver's license I can choose to operate in light sport whether I possess a medical certificate or not (as long as I can operate safely) and that I do not need to know that I meet the requirements for an AME issued certificate.
That is my experience with that ex. She mood swing for no good reasons and still thinks she’s perfectly fine. And was self medicating. And so on in many different ways.
Mental illness is very hard for those having it to be able to say they are ok. The very aspect of a person that makes decisions is the problem. It is nothing like physical disabilities.
Random people come onto this forum and asks this mental illness question every so often. And almost always as a guest account. I always cringe that they are still thinking of doing it, but I do understand why they ask. It’s not logical and when you have been up close with people who are in that condition you realize that is the core of it, nothing makes sense. And that they aren’t capable of fully making sense.
One of the things I noticed and read about is that often the ill person will say they are ok, it’s a misdiagnosis, and gives reasons for how they are fine and don’t have a problem. And that’s the thing how can they know when the part of them that thinks is the problem?
Situations like this should be handled professionally. And not by arm chair interpretation of regulations based on the potentially mentally ill person’s statements.
dbahn
Pattern Altitude
But you also need to consider that an accurate assessment of "bi-polar" may be lacking as well. Many of these diagnoses (sadly) are established by the need for a medical provider to list a code that provides reimbursement for the visit, and the reimbursement amount is often reflected in the severity of the code. (Sometimes the code is also needed to validate a prescription.) At the SP level, you would only need to have another physician state that the bi-polar diagnosis was incorrect and that the person has no condition that would prevent him from acting as PIC in the Sport Pilot category. He does not need to go through the rigorous and expensive FAA hoops to do that.
I don't know that anyone is suggesting that the decision be made entirely by the OP, particularly with this kind of diagnosis, but there is clear advice to consult a physician to help determine a course of action, and most of this discussion here involves the regulatory aspect of medical deficiency.
Kevin Holbrook
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Mountainlover
I prescribe these medications every week. I also stop them frequently when other people have prescribed them for inappropriate reasons. These medications are worthy of great respect.
If you believe that the conditions for which these medications are prescribed are compatible with flying, or if if you believe that these medicines are safe to take and fly on, there are bigger issues..
My completely non-medical opinion:
Step 1: Together with your doctor, determine what condition you actually have.
Step 2: Together with your doctor, determine what is the best medication for treating that condition.
Step 3: Make whatever switch from old medication to new medication is warranted by Step 2.
Step 4: Take some time to see how it affects you, whether it is effective, whether there are side effects, and whether the condition persists, etc. How much time? I don't know -- perhaps something like 6 months or a year. (Do not take this lightly.)
Step 5: Do an honest assessment at the end of Step 4, together with your doctor, about whether your condition is safely and consistently controlled. If it works only "most of the time", do not continue to Step 6.
Step 6: Think about learning to fly, and ask about whether your condition and its medications are compatible with flying. Do NOT do this until you have completed Steps 1-5.
Step 7: If at any time the assessment of your condition, or the medications you take for it, change, return to Step 3.
Gather documentation of all of this from your doctor as you proceed, as you may need all that paperwork at some point in the future.
--not a doctor.
Step 1: Together with your doctor, determine what condition you actually have.
Step 2: Together with your doctor, determine what is the best medication for treating that condition.
Step 3: Make whatever switch from old medication to new medication is warranted by Step 2.
Step 4: Take some time to see how it affects you, whether it is effective, whether there are side effects, and whether the condition persists, etc. How much time? I don't know -- perhaps something like 6 months or a year. (Do not take this lightly.)
Step 5: Do an honest assessment at the end of Step 4, together with your doctor, about whether your condition is safely and consistently controlled. If it works only "most of the time", do not continue to Step 6.
Step 6: Think about learning to fly, and ask about whether your condition and its medications are compatible with flying. Do NOT do this until you have completed Steps 1-5.
Step 7: If at any time the assessment of your condition, or the medications you take for it, change, return to Step 3.
Gather documentation of all of this from your doctor as you proceed, as you may need all that paperwork at some point in the future.
--not a doctor.
dbahn
Pattern Altitude
Pretty straight and accurate advice, even though you're "not a doctor".
The OP's earlier response (quoted below) hints that he in fact may not be bi-polar and if that's the case he may be taking medication that isn't needed but results in a mood change that he likes. (It wouldn't be unusual.) The OP would still need to discontinue that med or meds to verify that he's fine without them. (A pharmacist can probably advise the appropriate time period.)