SSRI

[Unregistered]

Alright here we go. I'm hoping to get a 3rd class medical, never been to see an AME. I started taking an approved SSRI several years ago and stopped taking it about 6 months ago. Here's where it gets dicey.

Not long after I started taking the SSRI, I also took another medication (supposed to "help" the SSRI). I honestly don't remember what it was without getting a copy of my records. It may have even been a sample packet and not a prescription. I took it for approximately a month.

Here's what worries me. On the page about SSRI SI on the FAA website it reads: the applicant does not have symptoms or a history of..... .....Multi-agent drug protocol use (prior use of other psychiatric drugs in conjunction with SSRIs.). Is my situation considered multi agent drug protocol?

I'm not trying to hide anything but I'm confused. Are those requirements ONLY for the SSRI SI and not pertinent to me since I'm no longer taking the SSRI? Or should I throw in my towel? Can anyone enlighten me here?

 

[AggieMike88]

First, welcome to PoA!!

Second, you came to a good place for this question. If you been lurking for a while, you've seen Dr. Bruce Chien post here. He is one of the authors of the SSRI special issuance protocol. He should be along soon. The best bit of advice from here is to follow his instructions. Do so and your chances of success will improve greatly.

 

[bbchien]

Unreg, FIRST of all you need to find out what the diagnosis was, for which you took the SSRI. Some are prohibited period (diagnoses), med or not (some of the anxiety disorders come to mind). PTSD. There are others.

Second, and more likely, IF you had situational depression, what you are going to need is a letter from the prescribing doc saying why you had the med(s), what they were, doses, and when you quit. There has to be a current visit (yes, you have to go and actually see the guy), that says:

(1) The "reactive" depression is gone (if that is what it was).
(2) No symptoms remain.
(3) No further need of treatment.

As you have only been off 6 months, you need an AME who can get approval, based on that letter, for a one year Special Issuance. It would be different if you were off more than a year, but Six months it is.

At the end of a year's issuance, another visit/another letter, and if the doc says, "hey nothing's happening" you get put back in the normal issuance pool.

Do NOT got to an AME until you have this letter, and the record(s). Yes, for the doc to write what's needed, you actually have to see the doc.

Then realize, most AME's will not issue this. They will want to do the exam, send in the documents (you need to send them in, too, just to be SURE FAA got them, certified return receipt), and then the wait begins. 100 days.

Try to find a HIMS AME. They're good at this stuff. There are about 100 of us. Are you near a reasonable sized city?

 

[Unregistered]

Thanks for the welcome!

The diagnosis was for OCD. I thought if you had stopped taking the SSRI for more than 60 days you could go in and get a normal issuance medical certificate? The person who originally prescribed the SSRI to me is no longer in the area. However, I had my family doctor (he's a physician assistant) renew the SSRI prescription. Would a letter with that information from him be acceptable?

So taking that other medication (to "help" the SSRI) along with the SSRI doesn't automatically disqualify me? Ill know exactly what it was soon, I've sent for a copy of my records. Thanks.

 

[bbchien]

You're not getting it. What happens next depends on what the DIAGNOSIS WAS. OCD can be either a neurosis (Axis 1) or a Personality Style (Axis 2), the latter does not affect decision making. If it's in Axis 1, it's not compatible with being PIC.

Thanks for the welcome!

The diagnosis was for OCD.

See the above. Which one?

I thought if you had stopped taking the SSRI for more than 60 days you could go in and get a normal issuance medical certificate?

Yes, if it's Axis 2, the OCD personality.

The person who originally prescribed the SSRI to me is no longer in the area. However, I had my family doctor (he's a physician assistant) renew the SSRI prescription. Would a letter with that information from him be acceptable?

So taking that other medication (to "help" the SSRI) along with the SSRI doesn't automatically disqualify me?

It has nothing to do with the second medicine. It has all to do with which diagnosis.

Ill know exactly what it was soon,

I doubt it, see below.

I've sent for a copy of my records. Thanks.

It totally depends on whether it was OCD or OCD personality. I sure hope your doc knows the difference. If he doesn't, there isn't anything that he can write that will help you. I really doubt a Physician Assistant has ANY insight in this regard, and the record will reflect that lack of sophistication. Even the supervising Family Practice Doc might not "get it". Real psychiatry is done by a psychiatrist, and it's really really easy for the FAA to tell who knows what they're talking about, and who hasn't got a clue. Then you get deferred and get a demand for a real opinion. A knowledgeable one.

Unreg, FIRST of all you need to find out what the diagnosis was, for which you took the SSRI. Some are prohibited period (diagnoses), med or not (some of the anxiety disorders come to mind). PTSD. There are others.

This is a fine, but important CERTIFY vs. DENY distinction. From the credentials of your caretakers, it is apparent there isn't one who might have a real clue for what they really gave you the SSRI. It's a good bet the Physician Assistant has NEVER SEEN a DSM-4 (Diagnostic and Statistical Manual, Am. Psychol. Assn, Version 4). It's a $700/year subscription volume and is pretty thick and dense.

The one favorable possiblity is if he's a Psychiatry P.A. That sort of PA just might know. If he's a family practice PA, NOT A CHANCE IN HADES. He had less than one month of psychiatric training....and that was by family docs, not psychiatrists.

I suggest that you make an appointment with a board certified psychiatrist for the 60-70th day, and bring your record from the Family Practice. Just about anything such a PA writes will result in demand for more detailed information, and failing that, DENIAL. You might as well get, what they are going to demand upfront....visit the psychiatrist, and not risk denial.

Sorry to rain on your parade but I've been down this road a hundred times. Going with what I think you have ends in denial. You need to get an expert opinion.

Once again, you have to not have Axis 1 OCD. Some of these can be okay on a year to year special issuance if on no meds. But most are denied. Axis II OCD is okay. But you don't seem to understand the distinction, and it's pretty clear nono of your practitioners made any attempt to teach you the distinction, and that suggests that THEY THEMSELVES don't understand the distinction. That bodes badly for the read of ANYTHING they write.