Long Term SSRI Use >5 Years

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AnotherSSRIVictim

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Got deferred for SSRI use as to be expected. What is the best path forward? I’ve been seeing a ton of different things….

I was deferred in November of last year.

AME said “can you get off?” “If so get off for 60 days and get a note from your doctor and we will send that in” That seems WAY to easy especially when dealing with OKC. They are also far from helpful when you call. I’ve seen that anything >5 years would reoccurring and be untreated and unmonitored which is false… it’s clearly being treated and monitored hence which is why I reported it… which is another thing they can deny on. Anyway right now it’s treated and monitored. It will remain monitored for as long as the FAA needs. If it involves yearly, or monthly aviation psychology evaluations so be it. But this seems like yet another FAA trap. But my question is, myself and doctor were talking and both think it’s time to possibly start coming off the medication. When I began treatment it wasn’t met to be a lifetime treatment. But will that give the FAA ammo to say “oh this is untreated now?” And stamp it denied. Or give a list of tests and evaluations, get thier kickback and still deny? Would I be better off staying on the SSRI so the FAA sees it as treated and monitored? I know that sounds sick, but from reading some of these forums they make anything involving an SSRI a loose loose situation. Seems like a game that anybody with SSRI history has to play. Just trying to see the best course of action moving forward. There has not been a break in treatment, a few medication changes at the beginning due trying to find one that is effective. Diagnoses code was Depressive Disorder Single Episode. This could all go to hell if coming off produces more speed bumps but I can’t say until we try.my doctor and I both seem optimistic just due to life style changes, and finding natural ways to help. I’d like to come off the medication regardless, but on the other hand I’d like to obtain a PPL, so while I see a lot of people saying screw the FAA do what’s best for you, I also don’t want to kill all chances because I went through treatment, treatment is now completed and the FAA finds another gotcha.
 
My understanding is that if u have been on and stable for a long time it’s hard to get off and go down that path as far as faa is concerned.
 
Obviously wait for an actual doctors advice, but when I started HIMS I asked about Path 1 vs 2, they told me they both take the same amount of time in terms of waiting on the FAA for paperwork. I don't really know how true that is, the office may just want my money, but its what they said.
 
Obviously wait for an actual doctors advice, but when I started HIMS I asked about Path 1 vs 2, they told me they both take the same amount of time in terms of waiting on the FAA for paperwork. I don't really know how true that is, the office may just want my money, but its what they said.
Dr Bruce did say that pathway I will not work for my case. It’s the recurred disease part that has me worried because honestly, being off SSRIs seems refreshing but in the case of the FAA since they will see the recurred disease it seems like that isn’t an option.
 
Until you are issued, the deferral means you are no longer eligible for sport pilot or whatever MOSAIC might bring in 2023 2024 2025.

After you are issued, will BasicMed be sufficient to meet your aviation goals?
 
See your private emails. Remember FAA has the congressional authority to define disease IAW what makes sense to the F.A.S for aviation. After 5 years especially when they occur in one's youth, they think it's pretty clear the docs keep the meds "ON" because they are afraid it will recurr. Most non psychiatry docs are TERRIBLE in doping out the risk factors for FUTURE recurrence, which is what matters here because FAA has to issue you in ADVANCE and hope you don't recurr in the six month period following. But it is pretty clear that with >5 years' duration the strong presumption is "disease is recurrent" and I have had only one HIMS Psychiatry consult in 27 years in which the consultant bucked that stream.

Then there is the ten year "reconsideration of the diagnosis" which can occur after a ten year period of no meds, no events, and well documented successful life test (of 10 years). If you can do/prove such a test, the presumption of recurrency is likely non applicable to your situation no matter what the docs think.
 
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Until you are issued, the deferral means you are no longer eligible for sport pilot or whatever MOSAIC might bring in 2023 2024 2025.

After you are issued, will BasicMed be sufficient to meet your aviation goals?
Yes that and Dr Bruce are the only light at the end of the tunnel here. Seems like it’s going to be hell to get an on SSRI SI, but hopefully it all goes through and I’ll switch to basic med as soon as humanly possible.
 
After 5 years especially when they occur in one's youth, they think it's pretty clear the docs keep the meds "ON" because they are afraid it will recurr.
Wonder what the FAA thinks about being on the meds for >5 years because it would be too much trouble with the FAA to come off them...
 
@bbchien, OP, or anyone for that matter would MOSAIC change the medical standard meaning if you have had a denied/deferred medical you could fly under those rules?

I also read someone on Reddit (the pilot experts just ask them) someone had a situation where they where denied, made a new med express account on a different email, applied, didn’t report anything, got their 3rd class, then went to basic med. Not sure how wise that is.
 
Wonder what the FAA thinks about being on the meds for >5 years because it would be too much trouble with the FAA to come off them...
That’s what I’m guessing. I really don’t want to be on the medication forever, but if I can atleast remain on them to satisfy the SI and switch to basic med, who knows what the future holds. From speaking to a few folks in the industry (surrounding basic med) that should atleast eliminate the recurrent costs. It is what it is at this point but atleast there is a plan moving forward. All we have is time, so 6 months stable does single medication will atleast give some time to save up for the tests, establish a HIMS AME and better prepare for the exam. The best news is that it’s doable. I’ve seen my share of success stories for on SSRI special issuances. So it’s motivating for sure to drive and grind forward.
 
@bbchien, OP, or anyone for that matter would MOSAIC change the medical standard meaning if you have had a denied/deferred medical you could fly under those rules?
Noting in Mosaic is proposed to change the medical rules. If your most recent medical with denied/withdrawn, you can not fly sport pilot. If your last application didn't result in an issuance (deferred), you can not fly either.

I also read someone on Reddit (the pilot experts just ask them) someone had a situation where they where denied, made a new med express account on a different email, applied, didn’t report anything, got their 3rd class, then went to basic med. Not sure how wise that is.
I strongly doubt this is going to work. Once an AME opens the application, the applicant is in the system. There's no way for him to do another application without the first denial coming to light (at least not without substantial perjury).

What you can do is bring the output of MEDEXPRESS to an AME for a consult and see if the AME sees if he would issue if he conducted an exam.
Then you could go back and either let the application timeout of MEDEXPRESS or start a new application with a different email. Of course, that would likely entail lying on the second applicaiton.
 
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Noting in Mosaic is proposed to change the medical rules. If your most recent medical with denied/withdrawn, you can not fly sport pilot. If your last application didn't result in an issuance (deferred), you can not fly either.


I strongly doubt this is going to work. Once an AME opens the application, the applicant is in the system. There's no way for him to do another application without the first denial coming to light (at least not without substantial perjury).

What you can do is bring the output of MEDEXPRESS to an AME for a consult and see if the AME sees if he would issue if he conducted an exam.
Then you could go back and either let the application timeout of MEDEXPRESS or start a new application with a different email. Of course, that would likely entail lying on the second applicaiton.
I still feel that even though the FAA is incredibly slow and not the brightest bulbs, if they get a second application for the same name, and DOB, that omits information provided on the previous one, it wouldn’t be difficult for them to find out. Even if it’s issued on site and then you jump to basic med right away, it seems it would be easy to say wait, this is the same guy/gal with a denied class 1 and now they are applying for a class 3, listing perfect health and jumping to basic med. Seems risky to create another med express account strictly to try and slip through. Although I’m sure people do and slip through, it seems risky as heck. In the case of this Reddit expert, he was denied already and brags about creating the second account, going to a different AME, and getting issued on the spot. He says it’s been a year and he hasn’t heard from them. Odd.
 
It's not even the FAA that will detect this. The new AME (unless he is corrupt) is going to find any previous applications.
 
When the wreck occurs, the insurance co will subpoene all the records and discover the fraud....and then refuse to payout. If you don't need insurance.....well nothing can stop you....google "barefoot bandit" for that.

 
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Seems shady either way. I got my roadmap and will begin the long road trip. In the end it would be worth it atleast that’s all one can hope for. Changing my email on and application and going to basic med will do nothing for me personally except make me check the mail every day looking for my revocation and perjury letter. I was given a guilty conscious. If that guy thinks it’s worth it so be it. Flying is important for me but not enough to falsify a medical application when things are easily obtainable.
 
@bbchien I am in a similar situation to the OP. I haven’t been one them for as long, just about 3.5-4 years but non the less on 2 (Zoloft/Wellbutrin) I am currently off of the Wellbutrin and beginning the Zoloft taper. My MD (board certified physiatrist) states that the diagnoses codes are Major Depressive Single Episode (In remission) and general anxiety order (in remission). She cited in remission for both.

Do you believe the process would be the same if I got off both compared to staying in 1? Will they still make you go through SSRI pathway 2 due to the concurrent use? My provider states it wouldn’t hurt to stay on nor hurt coming off. Trying to figure out the best approach. Thanks!
 
CoStudent said:
I am in a similar situation to the OP. I haven’t been one them for as long, just about 3.5-4 years but non the less on 2 (Zoloft/Wellbutrin) I am currently off of the Wellbutrin and beginning the Zoloft taper. My MD (board certified physiatrist) states that the diagnoses codes are Major Depressive Single Episode (In remission) and general anxiety order (in remission). She cited in remission for both.
....barring other DETAILS interfering (Federal psych reading your psychiatrist's record for risk factors and agreeing) getting off is your better bet.....
 
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....barring other DETAILS interfering (Federal psych reading your psychiatrist's record for risk factors and agreeing) getting off is your better bet.....
Thanks Dr. Chien,

Do you invision them asking for the physc evaluation, or CogScreen? I know it maybe hard to say. Anything you can provide as to what to have the doctor put in the letter to the FAA to better the chances of not going back and forth for years? Not asking for exact wording from them, just all the points to touch on. I know they want very specific information.
 
In addition (sorry for all of the questions) what should I send with the current progress not (or letter with your suggested topics) on the first go? I know they take longer to begin with so don’t want to miss a document that may cause this to go for months longer then it may need to. Thanks again Dr. Bruce!!
 
Sigh. I 'd have to see what all you'd sent them already to know how to answer that. Generally, though if you have a CURRENT progress office visit from an MD psychiatrist, I would send that in.
 
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Thanks Dr. @bbchien. All we sent in probably a year ago at this point was a progress note that both medications where being used in which they denied based off of concurrent use. I did seek an AME consultation that seemed to be confused because he said “both are on the approved list” so all they will need is a note. That’s clearly not the case. Can’t change the past.

I’ll be getting another exam and wanted to provide (hopefully) satisfactory reports for them to issue. Since there is a denial I’m sure it will have to be deferred again, so even if I can save a few months of waiting then mailing requesting more it would be nice. My provider even listed in the progress note that all though both symptoms are in remission and medications have been discontinued we will continue to have quarterly visits to monitor progress and report any changes to the FAA. Fingers crossed that satisfies. The information you provide and for no cost can’t be thanked nor appreciated enough. Only thing I wish is I found this page before my exam :-/

Thanks again Dr!
 
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