anti depressants

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I have prescriptions for xanax and lexapro.
The lexapro I take daily and the xanax is a rescue.
I take both for anxiety, and also ambian for sleep aid.
What kind of issues might I expect for a ppl medical?
 
What about the lexapro?
Honestly I can do without the xanax, they gave me a prescription, but I've never really taken it. The lexapro I do take daily though.

Is there some sort of time period I would need to be off the xanax?
 
You need to talk to an expert like Dr. Bruce Chien in Peoria. This is not something to take lightly when it comes to the FAA. Do not mess yourself up by going to a garden variety AME.

The underlying diagnosis is likely to be more of an issue than the medication.
 
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Obviously, you are underestimating the FAA's paranoia.

And, you were taking multiple medications which IS on the list of bad things.
 
Capt. Geoffrey Thorpe said:
You need to talk to an expert like Dr. Bruce Chien in Peoria. This is not something to take lightly when it comes to the FAA. Do not mess yourself up by going to a garden variety AME.

The underlying diagnosis is likely to be more of an issue than the medication.
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Yeah - you need to understand the FAA perspective on all this. They are interested in WHY you are taking these meds.
 
Capt. Geoffrey Thorpe said:
You need to talk to an expert like Dr. Bruce Chien in Peoria. This is not something to take lightly when it comes to the FAA. Do not mess yourself up by going to a garden variety AME.

The underlying diagnosis is likely to be more of an issue than the medication.
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:yeahthat:
 
Maybe I read that wrong. It says multiple SSRIs concurrently, xanax isn't an SSRI.

Thanks for the heads up about Dr. Chein. I just checked out his website and will send him an email.
 
"Multi-agent drug protocol use (prior use of other psychiatric drugs in conjunction with SSRIs.)" is also of concern (see the bullet point immediately following the point about multiple SSRIs on the page you provided a link to).

I'm not an AME, just a pilot reading the regs. Don't take my word for anything. Talk to Dr. Bruce Chien.
 
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Capt. Geoffrey Thorpe said:
You need to talk to an expert like Dr. Bruce Chien in Peoria. This is not something to take lightly when it comes to the FAA. Do not mess yourself up by going to a garden variety AME.

The underlying diagnosis is likely to be more of an issue than the medication.
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:yeahthat:

I do believe there will be some speed bumps with the ongoing use of Ambien. IIRC, small quantity, light occasional use can be worked around. But ongoing requires more action to get certified.

Dr. Bruce Chien is one of the best folks for your case. Reasons
  1. He is one of the 4 doctors who wrote the protocol to get SSRI's accepted
  2. He has done quite a few of these submissions successfully
  3. He knows the inner circle of CAMI very well and they him. They know when something is submitted from his office, it's done right. Therefore there is minimal delay on the decision to issue or not.

Dr. Chien can be found on the AOPA forums (requires membership in AOPA) or via www.aeromedicaldoc.com
 
Unregistered said:
...xanax isn't an SSRI.
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Google-fu found:

________________________
Alprazolam (Xanax)

Prescription drug -- Treats anxiety and panic disorder.

Brand names: Xanax, Niravam

Legal status: Schedule IV controlled substance

Pregnancy risk: Category D (Positive evidence of risk)

Drug class: Benzodiazepine

Other drugs in same class: Clonazepam, Lorazepam, Diazepam, More

May treat: Anxiety, Panic disorder, Agoraphobia, Depressive Disorder
________________________​

The AME's can provide the right answer, but I think the sedative aspect of Benzodiazepine will be the item of concern on Xanax.

Even if it's permitted to take while holding a 3rd class medical, you're likely grounded for a significant amount of time after taking a dose to allow the sedative affect to completely exit your system.

As before, seek out a very competent advocate style AME like Dr. Chien.
 
And get out your checkbook for $5000+ worth of psych testing and no guarantees.

I'd wait a few months and see what happens with reform.. AOPA is claiming action this month.

Sent from my SM-N910V using Tapatalk
 
Unregistered said:
What about the lexapro?
Honestly I can do without the xanax, they gave me a prescription, but I've never really taken it. The lexapro I do take daily though.

Is there some sort of time period I would need to be off the xanax?
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It's been a while since I've read Bruce Chien's posts on the Red Board (he no longer posts here), but I'm pretty sure the SSRI protocol is only for unipolar depression. I don't remember whether lexapro was one of the drugs approved under that protocol, but even if it is, that protocol doesn't apply if you're taking it for something else; in your case, anxiety. In other words, I think you're out of luck, sorry. :(

But, best contact Dr. Chien directly to get the full scoop, or over on the RB.
 
Nah, they'd rather just see you flying around un-medicated and not having ever consulted with a physician about your condition.
 
I am constantly amazed how more and more people seem to be medicating these days for being depressed, not being able to pay attention, being hyper, etc. There was a time that you rarely if ever heard of these sort of things. What seems to be the cause? Is it environmental or just increased awareness of long ignored problems or an out of control pharmaceutical industry acting as pushers?
 
SkyDog58 said:
I am constantly amazed how more and more people seem to be medicating these days for being depressed, not being able to pay attention, being hyper, etc. There was a time that you rarely if ever heard of these sort of things. What seems to be the cause? Is it environmental or just increased awareness of long ignored problems or an out of control pharmaceutical industry acting as pushers?
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Probably all of the above, but my money is on the latter.
 
SkyDog58 said:
I am constantly amazed how more and more people seem to be medicating these days for being depressed, not being able to pay attention, being hyper, etc. There was a time that you rarely if ever heard of these sort of things. What seems to be the cause? Is it environmental or just increased awareness of long ignored problems or an out of control pharmaceutical industry acting as pushers?
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I'd vote for that. The pharmaceuticals love taking your money.

"Here, take this and it will cure all your ills".

Never mind that it may create two more ills.
 
I'd add to the mix that in prior eras a good number of those affected would have simply self-medicated with heavier alcohol use than we might see today, or that still exists in developed countries.

 
DJTorrente said:
I'd add to the mix that in prior eras a good number of those affected would have simply self-medicated with heavier alcohol use than we might see today, or that still exists in developed countries.

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I am not sure if that has anything to do with it. Here is the caption from the website that your chart came from:

In the United States the per capita consumption of pure alcohol at present is 2.2 gallons but as this chart shows, the rate has varied wildly with the rise and fall of prohibition movements, health concerns, and availability of a good water supply. Adapted from David F. Musto's Alcohol in American History, Scientific American, April 1996
 
One pill makes you larger, and one pill makes you small
And the ones that mother gives you, don't do anything at all
 
Unregistered said:
Maybe I read that wrong. It says multiple SSRIs concurrently, xanax isn't an SSRI.

Thanks for the heads up about Dr. Chein. I just checked out his website and will send him an email.
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He may not respond to email promptly, it happens. Calling him is best.
 
Jesus dude, you need all that to make it through the day without freaking out, and you think getting into aviation where panic will straight kill you is a good idea?


picard.gif
 
James331 said:
Jesus dude, you need all that to make it through the day without freaking out, and you think getting into aviation where panic will straight kill you is a good idea?


picard.gif
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Do you think that maybe, just maybe, we should leave the diagnosing to the doctors and not some random guy on the internet? Hmmm?:idea:
 
James331 said:
Jesus dude, you need all that to make it through the day without freaking out, and you think getting into aviation where panic will straight kill you is a good idea?


picard.gif
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Not my problem, all this "safety, safety, safety" nanny state crap is screwing up our evolution as a species.
 
retailguy said:
Do you think that maybe, just maybe, we should leave the diagnosing to the doctors and not some random guy on the internet? Hmmm?:idea:
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They have

He's already been diagnosed, and agreed with said diagnosis, and is eating multiple pills daily to prove it.


Unregistered said:
I have prescriptions for xanax and lexapro.
The lexapro I take daily and the xanax is a rescue.
I take both for anxiety, and also ambian for sleep aid.
What kind of issues might I expect for a ppl medical?
Click to expand...

A "rescue"?!

Sorry if I'm not all sunshine and lollipops, but anyone that needs all that, let alone pills to be "rescued" from anxieties shouldn't be in high stress situation where freezing up, or freaking out, results in a fireball of carnage.

If the dude has that much anxiety just walking around in daily life, you think being solo, or with pax in a aircraft where everyone solely relying on him for their safety, is going to make him better?


Henning said:
Not my problem, all this "safety, safety, safety" nanny state crap is screwing up our evolution as a species.
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Well this is true.

How about he try his luck at skydiving or single pilot ultralights first.
 
retailguy said:
Do you think that maybe, just maybe, we should leave the diagnosing to the doctors and not some random guy on the internet? Hmmm?:idea:
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That's not really the issue, there is no diagnosing going on beyond what the OP is posting up. The realities of aviation are what they are, aviation will take your life with no compunction, and when things go wrong, they go wrong fast. How you react in an emergency is key to whether you and your passengers survive. The further into the crash you keep command of the energy, the more likely you are to survive. If you disconnect or melt down, everyone dies like AF-447, you just can't stop thinking and doing. Those who maintain thought control and keep acting, they are the ones that pull off the "miracle" landings with everything dead.

Thing is, I see no evidence between whatever normal life mental disorders and the person's reactions to extreme life threatening situations; mostly because there hasn't been any real studies done on the phenomenon. The difficulty is multiplied because those who react poorly aren't reported as such due to lack of ability after the event.
 
James331 said:
They have

He's already been diagnosed, and agreed with said diagnosis, and is eating multiple pills daily to prove it.




A "rescue"?!

Sorry if I'm not all sunshine and lollipops, but anyone that needs all that, let alone pills to be "rescued" from anxieties shouldn't be in high stress situation where freezing up, or freaking out, results in a fireball of carnage.

If the dude has that much anxiety just walking around in daily life, you think being solo, or with pax in a aircraft where everyone solely relying on him for their safety, is going to make him better?




Well this is true.

How about he try his luck at skydiving or single pilot ultralights first.
Click to expand...

He has CFI/dual and solo time ahead. Like I said, I don't see any evidence that makes your concern valid. Lots of good operators are nuts, it depends on what causes your anxiety. he might need all that because he's 40 living in his mother's basement still. If he's really a danger to himself, it'll most likely show up during solo time.
 
James331 said:
They have

He's already been diagnosed, and agreed with said diagnosis, and is eating multiple pills daily to prove it.




A "rescue"?!

Sorry if I'm not all sunshine and lollipops, but anyone that needs all that, let alone pills to be "rescued" from anxieties shouldn't be in high stress situation where freezing up, or freaking out, results in a fireball of carnage.

If the dude has that much anxiety just walking around in daily life, you think being solo, or with pax in a aircraft where everyone solely relying on him for their safety, is going to make him better?




Well this is true.

How about he try his luck at skydiving or single pilot ultralights first.
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First off, I don't take "multiple pills daily". I take 1 pill, lexapro, daily. I also have a prescription for xanax for instances when my anxiety gets really bad. I have used it 3 times in the last 18 months.
Second of all I don't have "That much anxiety walking around in daily life". I have a pretty stressful job that causes anxiety and sleep problems, mostly the inability to shut my brain off at the end of the day so I can sleep. I'm not homicidal, suicidal, or any other cidal.

I spend part of my week training people in live fire training exercises. So to assume that i couldn't handle high stress situations without freaking out is rather presumptuous.




As a note, I have been in contact with Dr Bruce and he said based on my history that I would be a good candidate for a special issuance for the lexapro if I want to spent the money on the psychological evaluations.
The other option is to stop taking the lexapro and after 60 days get with my dr, and if there are no advese side effects I can get a summary of support and not worry about needing the special issuance. This is the route I am going to pursue. If I can get off the lexapro all together I'll be happy. If I find that I'd rather keep taking it rhen I will look at the special issuance option.

Thanks for the advice everyone.
 
Unregistered said:
First off, I don't take "multiple pills daily". I take 1 pill, lexapro, daily. I also have a prescription for xanax for instances when my anxiety gets really bad. I have used it 3 times in the last 18 months.
Second of all I don't have "That much anxiety walking around in daily life". I have a pretty stressful job that causes anxiety and sleep problems, mostly the inability to shut my brain off at the end of the day so I can sleep. I'm not homicidal, suicidal, or any other cidal.

I spend part of my week training people in live fire training exercises. So to assume that i couldn't handle high stress situations without freaking out is rather presumptuous.
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Plus the ambian, making more than one pill -> multiple


Not picking a fight with you, after a couple emergencies, a bunch of students and a few flight hours I've delt with a couple people who would shut down when flustered, just saying, despite what a doc, who ain't flying with, may say be sure you're being real with yourself and be sure you're not underestimating what goes on in the cockpit.


Are people actually shooting at you during these live fire exercises?



Unregistered said:
...I'm not homicidal, suicidal, or any other cidal....
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IMO it might actually be better if that was the case, those folks are still functional, albeit in a not so good way, the anxiety seems to just appear in people, rendering some nearly useless



Like Henning said, if you're going to loose it it will be, hopefully, before your solo, I just hope your confidence in your mental state is well placed, because if you think live fire exercises stress you out, wait till your first real aircraft emergency.

Unlike your students, the ground and the airplane have zero hesitation or care in ending you.



Henning said:
He has CFI/dual and solo time ahead. Like I said, I don't see any evidence that makes your concern valid. Lots of good operators are nuts, it depends on what causes your anxiety. he might need all that because he's 40 living in his mother's basement still. If he's really a danger to himself, it'll most likely show up during solo time.
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Nuts is one thing, like the kid who let his chick cut on him, not quite normal but no biggie, people with anxiety are a little diffrent, and agreed on the CFI time.




I've said my thoughts on the matter, I'll step out of this one now


Blue skies.
 
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James331 said:
Plus the ambian, making more than one pill -> multiple


Not picking a fight with you, after a couple emergencies, a bunch of students and a few flight hours I've delt with a couple people who would shut down when flustered, just saying, despite what a doc, who ain't flying with, may say be sure you're being real with yourself and be sure you're not underestimating what goes on in the cockpit.


Are people actually shooting at you during these live fire exercises?





IMO it might actually be better if that was the case, those folks are still functional, albeit in a not so good way, the anxiety seems to just appear in people, rendering some nearly useless



Like Henning said, if you're going to loose it it will be, hopefully, before your solo, I just hope your confidence in your mental state is well placed, because if you think live fire exercises stress you out, wait till your first real aircraft emergency.

Unlike your students, the ground and the airplane have zero hesitation or care in ending you.





Nuts is one thing, like the kid who let his chick cut on him, not quite normal but no biggie, people with anxiety are a little diffrent, and agreed on the CFI time.




I've said my thoughts on the matter, I'll step out of this one now


Blue skies.
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I just don't agree with the assumption that mental state is indicative as to whether one "shuts down" or "speeds up" in a life threatening emergency. There has been shown no real correlation even, much less causation. I think it's a hard wired reaction at the core of the mind regardless of what is happening in the peripheral lobes.
 
Henning said:
I just don't agree with the assumption that mental state is indicative as to whether one "shuts down" or "speeds up" in a life threatening emergency. There has been shown no real correlation even, much less causation. I think it's a hard wired reaction at the core of the mind regardless of what is happening in the peripheral lobes.
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It's only what James thinks that matters. That's the beef that I have with the whole thing. You've got Doctors saying "this is possible" and he's saying it isn't. Its preposterous.

I have no idea if this guy can fly or he can't. Not my decision. But if you pursue it, "here's something you need to be aware of". That's my place, and ought to be his too.
 
retailguy said:
It's only what James thinks that matters. That's the beef that I have with the whole thing. You've got Doctors saying "this is possible" and he's saying it isn't. Its preposterous.

I have no idea if this guy can fly or he can't. Not my decision. But if you pursue it, "here's something you need to be aware of". That's my place, and ought to be his too.
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Where did I say it wasn't possible...
 
One may argue it's easier to kill someone in 'live fire exercises'. I've seen people accidentally shot

I have some anxiety and it makes me thrive in stressful situations. It doesn't always make people hang up.

Dr. Bruce will likely have him take a comprehensive and expensive psych eval for the FAA. Luckily he's not left to James' blanket prognosis for 'anxious' people.
 
"Training people in live fire exercises" could mean he is the glorified hall monitor at the local shooting range.

However, back to the issue at hand...

I know a guy that knows a guy that was on Lexapro. If you can manage your anxiety without the Lexapro, then get off the Lexapro for 60 days, be monitored by your prescribing Dr for 30 days, and get a letter from the prescribing Dr stating that the situational anxiety is under control without medication and you have no aftereffects from being off the Lexapro and go get a standard issuance.

Or go spend the money and roll the dice with a SI.

Or option three, which I will leave unsaid...
 
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