consumed 2 pills of SSRI through Telehealth, third class medical

Discussion in 'Medical Topics' started by harveypilot, Jan 23, 2021.

  1. harveypilot

    harveypilot Filing Flight Plan

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    I know consulting an AME is the best plan of action, but I dont have too many people I know, so I am reaching out to potential helpers here.


    1 year ago, I had undergone surgery (appendicitis), and a few days later, had trouble sleeping. Due to my stitches, I decided to do a Telehealth visit to some random doctor (paid online but out of pocket, without insurance) I found online. His prescription was Generalized Anxiety Disorder and prescribed me escitalopram. Just to 'get a taste' I only purchased 2 pills. I had observed side effects so I didnt get any more. And the sleeping issue was gone in a few days by itself so I didnt ever get any more.


    Now, after graduating out of college, I decided to pursue a PPL as a hobby, and have been going through quite a few hoops as a non citizen (that aspect is looking good so far), but I am really not sure what to do with this particular diagnosis situation.

    I should be able to go to walgreens and get the record that I only had 2 pills, based on other posts it seems that this information is going to be useful?


    What are my options here?

    1. should I plan for decision path 1 for SSRI meds?
    2. contact the doctor and get note saying I am done with the SSRI
    3. not mention it? I only had mild insomnia and not 'full blown' depression.



    I know LSA is an option but I would really prefer a PPL
     
    Last edited: Jan 23, 2021
  2. PeterNSteinmetz

    PeterNSteinmetz Pattern Altitude PoA Supporter

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    I would suggest doing a consult with an AME before formally starting an application with the FAA. See instructions at http://tinyurl.com/faaMedicalInfo .

    I suspect an SSRI decision path 1 should be possible given the history.

    Your option #1 will involve #2 but with particular wording.
     
  3. flyingron

    flyingron Touchdown! Greaser! PoA Supporter

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    I can't say how much I think the telehealth guy was a quack. A GAD diagnosis and psychoactive drugs on the basis of a single phone consult for a sleep issue? That's malpractice in my opinion.
    And yes, you're screwed now thanks to that quack. The FAA has been pretty hostile with regard to path 1 of late. You need a good AME to consult with.
     
  4. Half Fast

    Half Fast Final Approach

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    The issue isn’t the pills, it’s the diagnosis that was used to prescribe them. Get a consult with a good AME before you go further. Contacting Dr Bruce Chien would be a good idea.
     
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  5. AggieMike88

    AggieMike88 Touchdown! Greaser! PoA Supporter

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  6. bbchien

    bbchien Touchdown! Greaser!

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    Oh Jay_us. "Some Dr. thinks this man has an anxiety disorder". Worse he filled the script and created a pharmacy code...putting the Rx in nonconfidential territory.

    Needs Board certified psychiatrist's take on the situation B4 anything useful can be said. But for sure if you don't report it, it's findable.
     
  7. harveypilot

    harveypilot Filing Flight Plan

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    Thanks for the response. What is the approximate process for getting a psychiatrist eval? Can it be done with a few days or is it a long time consuming process?

    I also noticed the GAD is not listed as a use for escitalopram. Am I done for or is there still a chance? Most of my arguments are hooking on the fact that my diagnosis was wrong, especially given that it was online over only a few minutes.
     
  8. AggieMike88

    AggieMike88 Touchdown! Greaser! PoA Supporter

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    The original "I don't know it all" of aviation.
    You sure about that?

    upload_2021-1-23_21-39-40.png
     
  9. harveypilot

    harveypilot Filing Flight Plan

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    Oh!
    I was reading off of this:


    If the airman/FAA ATCS opts to discontinue use of the SSRI, the Examiner must notate in Block 60, Comments on History and Findings, on FAA Form 8500-8 and defer issuance. To reapply for regular issuance, the applicant must be off the SSRI for a minimum of 60 days with a favorable report from the treating physician indicating stable mood and no aeromedically significant side effects. See SSRI Decision Path I (PDF).

    An individual may be considered for an FAA Authorization of a Special Issuance (SI) or Special Consideration (SC) of a Medical Certificate (Authorization) if:

    The applicant has one of the following diagnoses:
    Major depressive disorder (mild to moderate) either single episode or recurrent episode
    Dysthymic disorder
    Adjustment disorder with depressed mood
    Any non-depression related condition for which the SSRI is used.

    But I think the last point

    Any non-depression related condition for which the SSRI is used.

    Would make me eligible.

    Okay that's a relief!
    I'll start in detailed consultation with, hopefully Dr. Bruce.
     
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  10. Tarheelpilot

    Tarheelpilot En-Route

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    Out of curiosity, how is it findable?
     
  11. Lindberg

    Lindberg En-Route

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    How sure are you that the diagnosis was GAD? Get your records and confirm; you'll need then anyway. Whatever the diagnosis was, you'll need to disclose it in the medxpress form. But if you are not taking the SSRI, don't put it on the form under medications you are taking. Note the form doesn't ask for all medications you've ever taken.
     
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  12. flyingron

    flyingron Touchdown! Greaser! PoA Supporter

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    A psychiatrist will want to meet with you enough times so that they can write the report. It may be a few sessions.
     
  13. Kenny Phillips

    Kenny Phillips En-Route

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    It is on the pharmacy record. It is rumored that Feds have cross-ref'd SSRI scrips with pilot records. Of course, that's just a rumor.
     
  14. DaleB

    DaleB En-Route

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    Don't feel like the Lone Ranger. Some doctors (even otherwise relatively good ones) prescribe meds like that for just about anything. Down because you lost your job? Worried about your kids? Just in a bad mood? Here, just take these. Here's a bottle of Zoloft. Congratulations, you just increased the cost of getting a pilot certificate by a few grand.
     
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  15. murphey

    murphey Touchdown! Greaser! PoA Supporter

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    Really?

    “The privacy you’re concerned about is largely an illusion. All you have to give up is your illusions, not any of your privacy.”
    Larry Ellison

    “You have zero privacy anyway. Get over it.”
    Scott McNealy

    If the insurance company knows, the FAA knows.
    If the state where you live knows, the FAA knows
    If the military knows, the FAA knows.
    Google knows Everything about Everybody.

    If any of you are ACM members, read this month’s CACM about Facebook.
     
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  16. Tarheelpilot

    Tarheelpilot En-Route

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    You used a lot of words and punctuation marks but did not answer the question.
     
  17. murphey

    murphey Touchdown! Greaser! PoA Supporter

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    Relational databases connected thru networks.
    If that doesn’t work due to technologies not playing well with each other, phone calls or written requests from one organization to another to provide requested data.
    Example - did you know that any staffer in Congress can access info in various Federal databases about anyone who’s ever been in the military or worked as a Federal employee or worked on a Federal contract? So much is in the OPM data stores.

    OPM Office of Personnel Management.

    Did you know that any staffer in Congress can call/email any of the Academies and get every bit of info on anyone who is attending that Academy? And that Academy tracks that person thru their entire career, retirement until they die. It’s known as Institutional Research or similar name.

    Many, if not all, the individual State driver license organizations are interconnected, or at least share data thru a common organization. Most also have access to various FBI databases.

    Let’s not even go into the databases of people with various categories and types of security clearances and access. Each of the Federal Departments have its own categories of clearances. But....the names of the individual shows up in the OPM, just not the classified details.
     
    Last edited: Jan 24, 2021
  18. harveypilot

    harveypilot Filing Flight Plan

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    Thanks guys for the responses.
    I must say I'm pretty disheartened at this. As a non citizen I had been going through the additional challenge of getting TSA approval and had hoped I could now focus on just my flying.


    How would a board certified psychiatrist evaluation work? Do I need any referral or can I ask them for an evaluation directly? Would anybody know how long it would take?
     
  19. flyingron

    flyingron Touchdown! Greaser! PoA Supporter

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    You can go to them directly, but you might ask a good AME (like Dr. Bruce) for the type of wording the FAA wants to hear. Generally, the "I find nothing that prevents this guy from flying safely," doesn't cut it. Statements that say he has examined specific aspects of your life (worrying, ongoing sleep issues, fatigue, irritibility, etc...) and find nothing that supports the GAD diagnosis and that you're otherwise high functioning without any life impacts.
     
  20. PeterNSteinmetz

    PeterNSteinmetz Pattern Altitude PoA Supporter

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    It can work out but will take some time and money.

    I would start with the AME consult and go from there.

    Also, as noted in my info page, link above, there are a number of ways for you to start your training while the medical issue is pending.

    Keep at it!
     
  21. harveypilot

    harveypilot Filing Flight Plan

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    I have had my discovery flight so far, and my first actual flight is scheduled tomorrow, but I am slightly hesitant to commit to training. I dont want to be $8k into training and find out that it will take 8 months to pass, or an additional $5k. This is never going to be my career so my budget is limited.
     
  22. Half Fast

    Half Fast Final Approach

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    Setting aside your medical concern for the moment,....

    Welcome to aviation. Be advised that everything always takes 8 months (or more) longer and costs $5k (or more) greater than whatever you planned. Flying and a limited budget don't mix very well.

    C'est la airplanes.
     
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  23. Tarheelpilot

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    How is any of that relevant to someone not in the military or federal OPM database? I know that insurance databases are linked to FAA but the op paid out of pocket and didn’t involve his insurance company. So how would the FAA know? What connections exist outside of insurance?
     
  24. Half Fast

    Half Fast Final Approach

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    The prescription is likely in a pharmacy database.

    Ever needed to refill a script while out of town? I bet the pharmacy was able to pull up your prescription data.
     
  25. hotprops

    hotprops Line Up and Wait

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    i think you knew the teladr was a quack after bringing it home from the pharmacy and googled what the drug was and flushed them all down the toilet. so you never took one problem solved.btw ask someone/ mod on this site to loose this whole thread asap
     
  26. Tarheelpilot

    Tarheelpilot En-Route

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    That’s impossible
     
  27. DaleB

    DaleB En-Route

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    Immaterial. Doesn't matter if he took any or not; even if he doesn't actually have a condition justifying the prescription, the diagnosis and prescription are what's going to cause the problem.

    Just my opinion, I have zero knowledge and it's just the opinion of SGOTI. :)
     
  28. bbchien

    bbchien Touchdown! Greaser!

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    Bad advice, and Not true. The pills were not documented to record, it's just an unsubstantiated "assertion".

    For god's sake do not that hotprops' TERRIBLE advice.

    The problem is some practitioner, With a license (APRN, PA, MD) though you had a condition that warranted the med.
     
  29. Lindberg

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    The pills aren't the issue The OP isn't currently taking them, so he doesn't even have to disclose them on the medical app. But he will have to disclose the diagnosis. That will be a issue.
     
  30. Half Fast

    Half Fast Final Approach

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    Bruce, can APRNs and PAs really prescribe these meds? I know PCPs get very little training in this area. Do NPs and PAs really get sufficient training to prescribe psych meds?
     
  31. harveypilot

    harveypilot Filing Flight Plan

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    In my case the doctor is an MD pediatrician
     
  32. av8npa

    av8npa Filing Flight Plan

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    Depends on the state, but in NC, yes. Including controlled substances if the practitioner has a DEA license. As for 'sufficient training', that's subjective.
     
  33. bbchien

    bbchien Touchdown! Greaser!

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    Yes and they don’t know what they don’t know. And any official contestation at the state level is labeled, “anticompetitive”.
     
  34. AdamZ

    AdamZ Touchdown! Greaser!

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    This right here!
     
  35. flyingron

    flyingron Touchdown! Greaser! PoA Supporter

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    Just wait until the psychologists get prescription authority. It was in the works in Virginia when I moved away. A friend was going back to take some "pharmaceutical" course that was going to be the prerequisite for her being able to write.