Previous SSRI use

W

Will

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I had been previously taking citalopram for anxiety/depression for a while (over a year). In July I was moved to Paxil, which I know is on the not approved list for FAA, however I only took this for about 3 weeks then stopped. So currently been off it for a around a month. During that time I was diagnosed with low testosterone which also causes symptoms of depression and anxiety and since started that treatment (6 weeks now) have no depression symptoms. My PCP disgnosed me with 'single depression episode with full remission' back in July. I read that FAA will consider you if you've been off Paxil for 60 days with no symptoms but if you've been on the meds for less than 6 months you need to be on it for 6 months. I don't want to go back on a SSRI so my question is if I wait 60 days since stopping the Paxil and have my PCP say I am clear of symptoms would that be ok?


Ideally I am applying for my 3rd class now but next year I will probably want to go for 1st class, was hoping 3rd class would less strict on the limitations.
 
I think you understand it pretty well. However, given the amount of time you spent on the various medications, the FAA may want something from an actual qualified psychiatrist rather than the uninformed guesswork and prescribing of psychoactive drugs by a general practitioner. I'd suggest talking to one of the HIMS docs on this forum prior to commencing an application.
 
The key is the total exposure to SSRIs, and never two at once (other than to change meds). If you have been on <6 months (per records) the AME can issue, provided the diagnosis is reactive depression and tha there has been NO prior episode IN YOUR LIFE, and the doc testifies to that.

Longer than 6 months to 2 years total exposure, off meds for 60 days, letter from the doc saying, the above, specifying dates of start and dates of end of treatment, and an office call >60 days after discontinuance, saying:

Reactive depression
No prior episode
Completely resolved
Stimulus to the depression (named, described) is gone
No symptoms remain to be treated.

...and the AME will defer you but the agency will issue you. It will be a special, requiring tha tat one year you get another such letter before you go back into the regular issuance pool.

Much beyond 2 years and you need testimony and history from a board certified psychiatrist. See, FAA doesn't treat family docs as having expertise in psychiatry (even less so, APNs, etc). They have about 3 week's of full time training in psychiatry- they've got good instincts but that's about all they'll say.
 
Thanks for the advice. Would you recommend going to a HIMS AME for the initial exam as they might be able to provide more background to FAA and be more likely to get it approved? I worry going to a standard AME might then cause more delay
 
Dr. Bruce Chien who responded up there ^^^ is a senior AME who specializes in difficult cases and special issuance. He was on the panel/committee with the FAA developing the rules and procedures to get a special issuance after using an SSRI.

Check out http://www.aeromedicaldoc.com/

He's near Chicago but helps/consults on cases outside the area. Excellent to work with and a pilot advocate.

He can tell you with 99% accuracy if you'll get issued before submitting the paperwork to the FAA.

I think it is $180 for Dr Chien to review your medical records etc. Money well spent, in my experience, to avoid a denial (which eliminates Sport Pilot) and best guidance to issuance.
 
OP since you ultimately want to go for 1st class I would absolutely take Terry's advice and consult with Dr. Chien. That way it'll all be cleaned up and you won't risk any gotchas in the future.
 
I guess "near" is a relative thing. Dr. B is in Peoria. It's 130 miles or so air distance and about 170 driving from Chicago, roughly about half way to St. Louis.
 
Ah, that is closer to civilization! My buddy (a patient of Dr. B) who lives in Peoria isn't going to be happy with the move.
 
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