Unusual SSRI Question

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I have a friend who's kind of an adopted son to me, who is thinking about learning to fly. He has a peculiar problem, however.

A few years ago, when he was about 25, he developed a phimosis and underwent circumcision. Since then, he's experienced problems with premature ejaculation, so his urologist placed him on Paxil, to be taken a few hours before, um, ehhr... You get the picture.

Is this a show-stopper, medical cert-wise?

He has no history of depression or any other mental health history.

Thanks.

-Rich
 
Unregistered said:
I have a friend who's kind of an adopted son to me, who is thinking about learning to fly. He has a peculiar problem, however.

A few years ago, when he was about 25, he developed a phimosis and underwent circumcision. Since then, he's experienced problems with premature ejaculation, so his urologist placed him on Paxil, to be taken a few hours before, um, ehhr... You get the picture.

Is this a show-stopper, medical cert-wise?

He has no history of depression or any other mental health history.

Thanks.

-Rich
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Yup. He's screwed.

I assume that if he quits taking it and can prove that he never really needed to take it, he may get a medical - but I would wait for a real response from a real AME before doing anything stoopid.

Consider LSA.

Forget about the mile high club.
 
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LSA is not an option if you're taking a drug the FAA says is incompatible with safe flight. My advice is to stand by and wait for Dr. Bruce Chien to drop by, but I expect he will be vitriolic in his approbation of a physician who prescribes psychoactive drugs without considering all the ramifications.
 
Ron Levy said:
LSA is not an option if you're taking a drug the FAA says is incompatible with safe flight. My advice is to stand by and wait for Dr. Bruce Chien to drop by, but I expect he will be vitriolic in his approbation of a physician who prescribes psychoactive drugs without considering all the ramifications.
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Um, the FAA says one cannot take insulin yet it is legal to fly LSA (or in my case as a PP on a SI) providing the endocrinologists signs off (like mine does annually).
 
Not Spinning in my grave said:
Where does the FAA say this, and where is this list of medications?
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It's not. In the 90s, the FAA considered publishing the internal document which contains their current algorithms. However, it's a live document. One dated December 20, 2009 may be completely out of date in February....medical thinking changes quickly. So it remains an "internal guidance" document.

In the case of SSRIs like paxil, both the med and the condition may be disqualifying.

If Department of Justice would just get around to signing off on the "simple depressive single med, in remission" SI, I would then be able to say the med itself is not DQ ing (in minidoses). But to date, I can't.

If he can find something else to do the same function, he could be certified. I'm currently working on a certification involving a "hot flashes" student in her 50s who was given one of these drugs for "hot and cold" vasomotor instability syndrome. Turns out, she'd rather fly and have hot flashes than the other way arouhnd.

not spinning in my grave said:
Where does the FAA say this, and where is this list of medications?
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See above. This is a part of administrative law that moves so quickly that they don't publish it. They would be awash if they tried.

Here's an example of an internal one that eventually got published (many of theses didn't exist one year ago.....):

Pharmaceuticals (Therapeutic Medications)
Diabetes Mellitus - Type II, Medication Controlled

  1. Code of Federal Regulations
  2. Medical History
  3. Aeromedical Decision Considerations
  4. Protocol
  5. Pharmaceutical Considerations
    1. Disease Protocol, Diabetes Mellitus - Type II, Medication Controlled
    2. Disqualifying Medication Combinations. Certification of airmen using meglitinides or sulfonylureas, along with beta-blockers is not permitted. Commonly used meglitinides include repaglinide (Prandin) and nateglinide (Starlix). Commonly used sulfonylureas include: acetohexamide (Dymelor); chloropropamide (Diabinese); tolazamide (Tolinase); tolbutamide (Orinase); glimepiride (Amaryl); glipizide (Glucotrol, Glucotrol XL); glyburide (DiaBeta, Micronase, Glynase); glyburide plus metformin (Glucovance); glipizide plus metformin (Metaglip).
    3. Allowable Medication Combinations: Certification of airmen using the combination of a beta blocker with the following diabetes medications is permitted: alpha-glucosidase inhibitors [acarbose (Precose), miglitol (Glyset)]; biguanides [metformin (Glucophage)]; thiazolidinediones [pioglitazone (Actos)]; DDP-4 inhibitors [sitagliptin (Januvia)]; and incretin mimetics [exenatide (Byetta)]. *
* The drugs in parenthesis are examples and are not all-inclusive.

kevin47881 said:
Um, the FAA says one cannot take insulin yet it is legal to fly LSA (or in my case as a PP on a SI) providing the endocrinologists signs off (like mine does annually).
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There are about 1,200 third class airmen flying who take insulin. There is an SI protocol for this. I have certified about 1% of them. AFAIK, we are the only western nation to allow this.
 
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Not Spinning in my grave said:
Where does the FAA say this, and where is this list of medications?
Click to expand...
It's in a paper they don't post publicly, but which AOPA has managed to deduce. See http://www.aopa.org/members/databases/medical/search_faa_meds.cfm. Since Paxil is psychoactive, it is a flat "no," without any of the "after review" or "based on stability of condition" or such. As regards flying as a Sport Pilot while taking a prescription med, you'll need a physician or other source (like the PDR) to tell you it does not affect your ability to fly safely. If you're taking a psychoactive drug like Paxil, I doubt you'll be able to get that, since Paxil comes with warnings about driving and operating machinery.
 
Ron Levy said:
It's in a paper they don't post publicly, but which AOPA has managed to deduce. See http://www.aopa.org/members/databases/medical/search_faa_meds.cfm. Since Paxil is psychoactive, it is a flat "no," without any of the "after review" or "based on stability of condition" or such. As regards flying as a Sport Pilot while taking a prescription med, you'll need a physician or other source (like the PDR) to tell you it does not affect your ability to fly safely. If you're taking a psychoactive drug like Paxil, I doubt you'll be able to get that, since Paxil comes with warnings about driving and operating machinery.
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Yup. He needs to use SOMETHING else for the same purpose which ain't a psychoactive.

90 days off the med, and a doc's letter will do the job.
 
Ron Levy said:
No, they don't. They say you can't fly if you're a diabetic unless you meet certain additional criteria. Not at all the same.
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Just out of curiosity; why would one take insulin if one wasn't diabetic? As for the additional criteria, I'm certain I know each and everyone as I need to submit for an SI annually.
 
bbchien said:
There are about 1,200 third class airmen flying who take insulin. There is an SI protocol for this. I have certified about 1% of them. AFAIK, we are the only western nation to allow this.
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I am one of 1,200 :yesnod: My medical states it is only valid within the USA.
 
I kind of suspected that would be the answer. Thanks.

BTW, I'm only posting this unregistered because my friend is concerned that someone on the board might meet the two of us together in person some day and remember this thread, and he would be embarrassed. I personally think that's a little far-fetched, but then again, I'm not walking in his shoes.

But out of habit, I signed the post anyway, lol. No matter. It's generic enough.

I'll suggest that he talk to the urologist about some other way to deal with the problem that won't ground him before he makes any commitments to start training.

Thanks again.
 
Unregistered said:
I'll suggest that he talk to the urologist about some other way to deal with the problem that won't ground him before he makes any commitments to start training.quote]

I'm told that the sore throat spray (cepostat or something like that) works well when sprayed on yer little buddy...
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Unregistered said:
I kind of suspected that would be the answer. Thanks.

BTW, I'm only posting this unregistered because my friend is concerned that someone on the board might meet the two of us together in person some day and remember this thread, and he would be embarrassed. I personally think that's a little far-fetched, but then again, I'm not walking in his shoes.

But out of habit, I signed the post anyway, lol. No matter. It's generic enough.

I'll suggest that he talk to the urologist about some other way to deal with the problem that won't ground him before he makes any commitments to start training.

Thanks again.
Click to expand...

What, is he worried one of us will walk up and go, "Hey, you must be "quick draw", I read all bout you...."? Well... I might...:D:aureola:
 
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