Deferred 3rd Class for OSA and SNRI

[Chris E]

I applied for a 3rd class medical certificate for the first time in May 2018. I had the exam on May 18 and was deferred because of my obstructive sleep apnea diagnosis and my use of Venlafaxine, which is an SNRI, an antidepressant. The AME told me to get a letter from both my psychiatrist and the physician who oversees my CPAP use stating that I am "medically fit to fly." I requested as much from both. In meeting with my psychiatrist I decided to discontinue Venlafaxine because I assumed it would be easier to obtain certification in the future off of Venlafaxine. The documents were sent to the FAA on June 11. The FAA says they received my application on July 2. I took my last dose of Venlafaxine on July 4. I call the FAA once a week for an update and they haven't taken any action. My questions are: Have I sent the proper documentation to the FAA? What will the FAA say? What will be different when I apply in the future without a reported medication? Will I need recommendation from my psychiatrist? Thanks.

 

[AggieMike88]

The best person to amongst us PoA folk to comment on your case is Dr. Bruce Chien (aka @bbchien). Not only is he one of the most respected AME's in the biz, but also one of the four authors of the protocol the FAA uses for reviewing applications that involve medications taken for psychiatric and psychological issues.

The rest of us would just be guessing at what is the right course of action.

If you wish to make private contact with him, you can initiate a conversation by going to his website, www.aeromedicaldoc.com, and following the directions on the "How To Start" page.

 

[AggieMike88]

For "completeness" of information, there are two pathways in which a medical can be granted when the applicant has use of an SSRI in their history. Info about that can be found here: https://www.faa.gov/about/office_or...process/exam_tech/item47/amd/antidepressants/

And the SSRI used is one the following (single use only):

• Fluoxetine (Prozac)
• Sertraline (Zoloft)
• Citalopram (Celexa)
• Escitalopram (Lexapro)

However, I was not able to find any information about when an SNRI is involved. So best wait for guidance from Dr. Bruce.

 

[bbchien]

For "completeness" of information, there are two pathways in which a medical can be granted when the applicant has use of an SSRI in their history. Info about that can be found here: https://www.faa.gov/about/office_or...process/exam_tech/item47/amd/antidepressants/

And the SSRI used is one the following (single use only):

• Fluoxetine (Prozac)
• Sertraline (Zoloft)
• Citalopram (Celexa)
• Escitalopram (Lexapro)

However, I was not able to find any information about when an SNRI is involved. So best wait for guidance from Dr. Bruce.

ugh. This one will be denied. Venlafaxine is not licensable. So the next questions are:
Do you know the precise psychiatrist’s diagnosis for which you take it;
How long have I taken it
Did you EVER take two
Depression meds at the same time?
If for depression, was there ever suicidality that will appear in a record?
Ever any suicidality
Ever a hospitalization?
Ever had a prior episode
...since these determine decision path one. Or two....
...since that is a bit much to post pm a public forum....Might try my signature line and send me an eMail?

 

[Chris E]

The diagnoses are depression and anxiety. I have taken several different antidepressants since at least 2015 but never more than one at a time. I was taking Venlafaxine for about a year until July 4. There is no record of suicidality nor hospitalizations.

 

[lbfjrmd]

This will require the HIMS route with a HIMS-AME. The FAA will be responding - can take a month or 2!

 

[BillTIZ]

The diagnoses are depression and anxiety. I have taken several different antidepressants since at least 2015 but never more than one at a time. I was taking Venlafaxine for about a year until July 4. There is no record of suicidality nor hospitalizations.

Call Dr Bruce and follow his advice to the letter.