Prozac?

Discussion in 'Medical Topics' started by MontanaMan, Feb 14, 2018.

  1. MontanaMan

    MontanaMan Filing Flight Plan

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    Hi Folks:

    I'm interested in eventually getting a private license, after getting the sport license. I'm concerned because I've been prescribed Prozac in the past for depression. I've heard that the FAA now allows "Provisional" medical status, despite the depression.

    Can anyone explain in plain english how that works? I've found some very confusing info on it, and I'm still not understanding it.

    How much trouble will it be to get the medical clearance with a history of Prozac?

    Thanks!
     
  2. murphey

    murphey Final Approach

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    Contact Dr Bruce Chien

    aeromedicaldoc.com

    do not pass go.
    do not collect $200
     
  3. MontanaMan

    MontanaMan Filing Flight Plan

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    Thanks ... I just sent him a message from his website.
     
  4. bbchien

    bbchien Touchdown! Greaser!

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    For everyone's information:

    (Not about Montana Man) If one has had more than one episode of depression/anxiety in a lifetime, that is by definition "recurrent depression". If you are off of all meds, that means, "recurrent disease, untreated" which is DENIED.

    If one is ON meds, the only way through is on the SSRI depression protocol which is not for the faint of wallet.

    It is not normal to go through life and be on and off the meds, then on, then off, then on.....etc. That speaks of an underlying difficulty which will in fact, recur again.

    I have another pilot who just got denied for "recurrent disease, untreated" and is setting up for the long march (6 months stable on single med, unchanged dosage) to the SSRI issuance. The FAA view rather darkly, "I threw away my pills and I'm fine!"
     
  5. Ann Other

    Ann Other Guest

    Hi Dr Bruce - I realize that you're the authority on this topic, so I'm just trying to make sure I understand your answer above wrt the "two incidences" rule...

    Got my 3rd class a long time ago. Even further back in the mists of time I saw a therapist, which was very helpful to me. I discussed this (perhaps more than I was required to do, but what's done is done...) with my first AME. Since he wanted to know why, I (self-)described the symptom that had prompted this as "moderate anxiety". Never diagnosed as such by a medical doctor. No drugs prescribed or taken, obviously.

    Regardless, FAA requested a letter from my therapist stating "resolved, no indication of being a danger to herself or others, no substance abuse noted". Once supplied, OK issued my medical.

    Is that effectively my "first strike", i.e. if I were ever to see a doc about anxiety (or depression) from here on in, even if clearly "situational", I would be considered as having a recurrent condition and done flying (short of taking SSRIs forever, as I read you)?

    I'm a recreational pilot with no desire to hold anything higher than 3rd class, if it makes a difference.

    Thanks!
     
  6. Capt. Geoffrey Thorpe

    Capt. Geoffrey Thorpe Touchdown! Greaser!

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    Then get your third class now (before anything else goes wrong), assuming that "a long time ago" means that you didn't have one as of July 14, 2006 and then look at the basic med option. https://www.faa.gov/licenses_certificates/airmen_certification/basic_med/
     
  7. bbchien

    bbchien Touchdown! Greaser!

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    As there's a lot at stake I would get your FAA Medical record and read it. Anxiety without need of treatment can count if there is a second episode that DOES require treatment. I would want to see the letter, that she wrote.
     
  8. A.N. Other

    A.N. Other Guest

    Thanks, Dr. Bruce (and Capt. Thorpe for the BasicMed point). I looked for a copy of that letter and couldn't track it down, so I'll request my file from the FAA.
     
  9. Dr Bruce

    Dr Chen, my 19 yo son is taking college classes for the first time and going through some other life changes, and our family physician thought he might be going through a "Freshman Depression" that he said is common and put him on Zoloft, which he thought he might be on for a year (our doctor himself who looks about 30 went through the same thing and took Zoloft for a year before going off and being fine since.) He has taken a low dose for a month. Don't think he has noticed a big change but we will see when they up the dose to the normal 50mg. He is concerned this has ruined his chances of being a commercial pilot someday and perhaps so. Not sure if your post meant that he better to stay on the Zoloft indefinitely in order to get his Medical Exam, or to be off? And if off, is there an amount of time he should be off before getting an exam done?
     
  10. bbchien

    bbchien Touchdown! Greaser!

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    Yeesh. We do what's medical best, but he's now made his path quite complex and it will likely require a psychiatrist.
    In fact, I'd suggest him seeing one just to make sure this is really necessary. The certification difficulty has already been incurred, so you now might as well go to "someone who knows" BEFORE the dose is escalated and symptoms if any are still apparent.

    IMO, PCPs should NOT be handing this stuff out without an immediate evaluation referral.
     
  11. F01LA

    F01LA Pre-takeoff checklist

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    Interesting.. And it makes me curious. Take the case of someone who has gone through several difficult times in their life and found SSRIs to be helpful, but stopped the meds when things got better. From the FAA's perspective, should they have stayed on the meds the whole time? Or maybe they shouldn't be a pilot at all?
     

  12. Good questions, would like to know the answer to this also.
     
  13. From the FAA's perspective, I think they'd prefer that such a person not be a pilot at all, given how much of a hurdle it is to get a third class at that point. I happen to be one of Dr. Bruce's SSRI applicants, and I first applied for a third class after discontinuing the medication. Unfortunately, I had stopped taking the medication a few times many years ago, but took it up again if I felt a little anxious. Apparently that was the WRONG ANSWER TO GIVE THE FAA, and I was rewarded with a denial for my efforts ("We think you have dysthymia. If you ever had a medical, you don't now." Not quite those words, but that was the gist of it)

    My only choices at that point were to A) give up and take up stamp collecting or B) certify on-medication. I'm not about to give up on a lifelong love of aviation, so (B) it is. Unfortunately, it is a long, expensive, very frustrating road - visits to a board certified psychiatrist, meetings with an HIMS psychiatrist, the full Cogscreen AE test battery... I'm now just over 7 months since my most recent meeting with Dr. Bruce, and I'm hoping for good news any day now, but the FAA moves at a pace that can only be described as 'glacial'.

    After all this, I feel really badly for a generation of kids who have been prescribed medication like it came from a Pez dispenser - if any of them ever wanted to fly, they'll be in for some incredible disappointment later on in life.
     
  14. bbchien

    bbchien Touchdown! Greaser!

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  15. PaulS

    PaulS Final Approach

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    I hope it works out for you.