SSRI Denial Letter

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TheNoobishPilot

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TheNoobishPilot
Hi All,

I’m hoping to get some information as my letter didn’t really state much so I’d like to know what to expect. I currently take 2 SSRI medications (Zoloft and Wellbutrin), which prompted the denial of my medical certification. I was speaking to my physician and they are comfortable ending only 1 or even both medications.

My question is, if both are discontinued will I have to still go through all of the same testing as if I remained on 1? Will the requirement to work with a HIMS still be there? I know pathway 1 states that discontinuing medications for 60 days would be to reapply. But I have a hard time believing they would just simply issue without additional testing. Also would reapplying consist of another medical physical?

I truly thank anybody that can provide some clarity. I am extremely overwhelmed and discouraged at this point
 
Anthem said:
yes to almost all of your questions. 60 days is a pathway. The pathway doesnt have a fast track that you would qualify for.
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So getting off of one of the medications for 60 days and then getting a whole other physical done will bypass the HIMS AME route? I’m just asking because you mention 60 days is a pathway but there is no fast track?
 
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It will be 6-9 months of appointment making and document submissions then waiting for OKC to process and approve a Special Issuance valid for 6-12 months. Best case. Then you can continue following their instructions for renewal or go Basic Med.
 
FatherPilot said:
It will be 6-9 months of appointment making and document submissions then waiting for OKC to process and approve a Special Issuance valid for 6-12 months. Best case. Then you can continue following their instructions for renewal or go Basic Med.
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That’s even after of getting off one or both of the meds?
 
TheNoobishPilot said:
So getting off of one of the medications for 60 days and then getting a whole other physical done will bypass the HIMS AME route? I’m just asking because you mention 60 days is a pathway but there is no fast track?
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It's actually 6 months now, not 60 days (despite some FAA publications to the contrary). However, if you have ever been treated with multiple agents, you are not permitted to use that path.
 
flyingron said:
It's actually 6 months now, not 60 days (despite some FAA publications to the contrary). However, if you have ever been treated with multiple agents, you are not permitted to use that path.
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Ok I called the FAA who confirmed 60 days. However, I was treated with 2 medications so what should the next steps I take be? I’m honestly just lost
 
It's a catch-22 getting off the meds: Great! you are off the medication, doing better. But since you needed them, going forward we have to monitor you and make sure you don't need them again. There's no backsies, forget about that SSRI thing it's in the past...permanent record.
 
FatherPilot said:
It's a catch-22 getting off the meds: Great! you are off the medication, doing better. But since you needed them, going forward we have to monitor you and make sure you don't need them again. There's no backsies, forget about that SSRI thing it's in the past...permanent record.
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And you said “we” are you with the FAA? And do you offer consulting service?
 
FatherPilot said:
It's a catch-22 getting off the meds: Great! you are off the medication, doing better. But since you needed them, going forward we have to monitor you and make sure you don't need them again. There's no backsies, forget about that SSRI thing it's in the past...permanent record.
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Not entirely true. The situational depression tool allows fast track issuance for SSRI usage of less than 6 months. The depression and anxiety tool allows fast track issuance for SSRI usage discontinued for more than 2 years.

Unfortunately the simultaneous use of more than one psychoactive medication is disqualifying for both fast tracks and requires deferral.
 
Actually decision path one is, pratically, only availabe to those whose whole psychiatry course is
(1) < 5 years
and
(2) has not had a period of off meds and then back on meds.
That's not published but part of the criteria for "recurrent disease".

Recurrent disease, untreated and unmonitored is 100% denied. Fast tracks also exclude "recurrency".
 
bbchien said:
Actually decision path one is, pratically, only availabe to those whose whole psychiatry course is
(1) < 5 years
and
(2) has not had a period of off meds and then back on meds.
That's not published but part of the criteria for "recurrent disease".

Recurrent disease, untreated and unmonitored is 100% denied. Fast tracks also exclude "recurrency".
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glad to see your back doc!
 
Is anybody able to provide assistance as to what the next steps are for somebody in my situation. I honestly don’t know what to do at this point or if it’s worth even pursuing
 
bbchien said:
Thanks. Noobish just need some help. He might NOT have a pathway and there's nothing worse than banging your head against the wall if you might never meet spec....

.....And we'll see how long the attached holds out....
View attachment 138101
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Thank you. If there is any information you can provide. I’m just trying to see if my dream is dead or if it is possible to get this done. I can’t believe the lack of support from the FAA when the letter indicates nothing
 
All,

Thank you for your advice and guidance. I have contacted my AME, Treating Physician and OKC who all 3 said to write a letter to the FAA indicating that I am working on getting off one of the medications. Wait the time of being off, then submitting another letter with a favorable physician report (if all works out) and wait for them to ask for additional information or issue. I really appreciate all of you!
 
Anthem said:
im curious Doc @bbchien - for someone who has been on multiple drugs like the OP. If they got off of one for the required amount of time, is pathway II available to them in any sort of capacity. It will obviously be tricky but more from a curioisty point of view. or is ever having multiple psych drugs disqualifying forever going forward ?
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Great question. Not much is out there regarding dual SSRI use except you can’t be on both and get any class of medical.

What if it is dropped down to 1 or even if they are completely removed from them? The internet is a tricky place because I personally have seen a wide variety of answers such as “I got off both, waited 6 months, got a favorable report, and my medical came in the mail”

All the way to “I’m 20 months in and still waiting”

If anybody has first hand experience starting by using 2 SSRIs and then going down to one (or even none if you’re treatment is complete) to getting a medical certification.
 
Currently anyone with dual ss/snri combos at any time in the past is excluded due to “severity index”.
 
Certification aside, if you needed those 2 medications, stopping one or both could have some really bad downsides. Withdrawal from antidepressants is a big deal. Dysphoria, feeling lost, suicidal ideation, return of the original depression/anxiety symptoms. If you do come off of them, make sure you do it under the direction of a legit physician. I doubt your PCP said you can just come off one or both, like it is no big deal. And if he/she did say that, probably get a second opinion. It is not usually that easy. Good luck
 
Just got the denial for my daughter who is on citalopram for mild generalized anxiety. She passed all the cog screens, was recommended by all parties who evaluated her and even flew with a CFII with over 20,000 hours and wrote her a glowing recommendation. She’s in college for a BS in Aviation Management with flight. She’s thriving, making the Dean’s list, participating in school clubs, on the board of her aviation sorority, etc…. We are at a total loss as to why and are waiting on the paperwork. Our congressman’s office has been involved and called us today with this news. Can any of the medical professionals here offer any insight or encouragement?
 
RSquaredF16 said:
Just got the denial for my daughter who is on citalopram for mild generalized anxiety. She passed all the cog screens, was recommended by all parties who evaluated her and even flew with a CFII with over 20,000 hours and wrote her a glowing recommendation. She’s in college for a BS in Aviation Management with flight. She’s thriving, making the Dean’s list, participating in school clubs, on the board of her aviation sorority, etc…. We are at a total loss as to why and are waiting on the paperwork. Our congressman’s office has been involved and called us today with this news. Can any of the medical professionals here offer any insight or encouragement?
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What was the reasoning on the letter for the denial? I see you’re waiting for the paperwork so wait for that and get an understanding as to why. They maybe requesting additional information. In any case they should give reasoning as I believe that medication is on the approved list if it is denial.
 
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The letter was very ambiguous and only asked for mental health updates, which we assume means more travel and paying the same Drs to do what they did a year ago. Nothing has changed in this year since we submitted, yet we now have to jump through all the hoops again. Meanwhile, she’s run out of college courses to take towards her degree. Is there any hope?
 
What it sounds like happened in your case and I could be wrong is that you put together the packet a year ago and waited for a response. Was there any on going follow ups between her and her AME? The FAA can’t issue without current information and it sounds like that’s what is missing.
 
RSquaredF16 said:
The letter was very ambiguous and only asked for mental health updates, which we assume means more travel and paying the same Drs to do what they did a year ago. Nothing has changed in this year since we submitted, yet we now have to jump through all the hoops again. Meanwhile, she’s run out of college courses to take towards her degree. Is there any hope?
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Man, that sucks. Sorry to hear that and I hope the FAA starts reevaluating the metrics they use for issuance/denial for anxiety cases…or at least doesn’t make you wait a year to find out.
 
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