3rd Class Medical - SSRI / Anxiety - Best plan going forward?

[Bob Sacamano]

I have recently done a couple of discovery flights and I am looking forward to beginning training, but I also do not want to waste a lot of time and money if my path is not obtainable.

As a bit of a brief backstory I never had any issues until a closer family member passed away a few years ago. After that I did have several anxiety attacks which I did not understand. I would feel my heart rate elevate and think I may be having a heart attack - a pretty common misunderstanding for people in that situation. I went to the ER a few times to make sure I wasn't dying after which I got a handle on what was going on.

My PCP retired a couple of years ago and I have seen another doctor a couple of times at his practice, but due to the pandemic I used an on-line service that ultimately prescribed Lexapro / Xanax (for acute episodes). Lexapro started around December of 2021. At one point in April the prescriber tried Sertraline instead due to weight gain side effects, but I discontinued after about 2 weeks due to GI effects. Similarly, in July she tried Lexapro w/ Bupropion, not for its cognitive properties, but to combat weight gain as weight loss is a noted side effect. I tried that for about a month with no effect, so I also discontinued usage. Since I've been established on Lexapro, I have not had any issues and only took a couple of low-dose Xanax at the start. My former PCP had also issued me a few pills of low-dose Xanax years ago when flying. This was much more related to disliking not being in control, tossed in the back of a van in the air, rather than a fear of flying, and being able to sleep during rides was a benefit too.

I don't know if the fact I took the Lexapro / Bupropion together for a month to combat weight control issues will simply be a death knell or how much time I need to wait given my history.

Sorry for the long post, but I wanted to know if I had a realistic path to getting a medical clearance at all. I live in the Northeast, and would love to start training now, a little before winter, but with all of this up in the air may not be my best move due to how long it could take. Would it make more sense to see if this is viable, knock out whatever I need to do including ground school, and then start with a CFI in the spring?

I did have an appointment with a HIMS-AME, but they wanted me to register online with the FAA etc before coming in for the appointment. I didn't want to go that route before I had an idea of what I may be facing. I cancelled that appointment and will re-examine it soon.

This forum and the insight provided is incredible.

 

[flyingron]

Get a different HIMS AME. You do not want to commence an application without knowing what you are up against. Dr. B even suggests you get all your tests in a row before doing so.

Buproprion is a NO-NO unconditionally no matter what you are taking it for (even smoking cessation). Multi-drug treated conditions are also going to be a near-impossible case (though possibly if you can get down to one, it can happen). The other problem is your mix of underlying conditions. Each of these is also going to need to be addressed in addition to whatever drug use you are on.

 

[Bob Sacamano]

Just to be clear (and I'm not sure if it matters) Lexapro is the only med I am on. I'm also not sure what you mean about multiple underlying conditions as it has been an anxiety issue unless I'm missing something. The weight gain was relatively mild, just annoying which is why the prescriber tried those. I didn't see any change and didn't want to take two meds needlessly.

Do I need to be on my current dose, unchanged for 6 or 12mos? I feel like either way it probably doesn't make sense to start instruction until that is sorted (if it's even possible).

Reading these resources is why I pulled the plug on that AME as I didn't want to lock into a process I didn't understand. Thanks for your reply.

 

[lbfjrmd]

find a HIMS ame that will see you for a consultation first. Then be willing to take instruction! Engage him/her and start the process.

 

[bbchien]

find a HIMS ame that will see for a consultation first. Then be willing to take instruction! Engage him/her and start the process.

Everyone who has posted in this string is CORRECT!

 

[Half Fast]

Step 1 - Why do you want to fly?

If it's just for fun and you can be content with daytime VFR flying, seriously consider a Sport Pilot certificate rather than Private Pilot and fly Light Sport Aircraft. Your driver's license is all the medical you'll need, and you can fly LSAs with one passenger anywhere in the US and the Bahamas. That's plenty of capability for many pilots.

If you have a need to fly larger aircraft than LSAs, though, or if you want to fly commercially, then you'll need to go through the hoops as discussed above. This will be time consuming (possibly years) and very very expen$ive.

So think carefully about Step 1. Just exactly what do you want to do with an airplane?

 

[58driver]

Step 1 - Why do you want to fly?

If it's just for fun and you can be content with daytime VFR flying, seriously consider a Sport Pilot certificate rather than Private Pilot and fly Light Sport Aircraft. Your driver's license is all the medical you'll need, and you can fly LSAs with one passenger anywhere in the US and the Bahamas. That's plenty of capability for many pilots.

If you have a need to fly larger aircraft than LSAs, though, or if you want to fly commercially, then you'll need to go through the hoops as discussed above. This will be time consuming (possibly years) and very very expen$ive.

So think carefully about Step 1. Just exactly what do you want to do with an airplane?

Sir....Love your advice of "Why do I want to do this??" I never knew about Sport Pilot until I joined Pilots Of America!! I'm at the point of going sport pilot just to get back in the air! All of it, radio calls...traffic pattern work, etc...I started the process back at the end/ middle of 2019 and Covid 19 put an end to all of that..for now!!! Thanks again sir!