Xanax and other anxiety meds

Discussion in 'Medical Topics' started by Unregistered, Jan 13, 2011.

  1. Unregistered

    Unregistered Guest

    I am have some difficult issues at work and its creating great anxiety in my life.

    Are there any anxiety meds that are OK with the FAA? I assume stuff like Xanax is not OK. Correct?
     
  2. Gary F

    Gary F Final Approach

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    I know of a guy who was grounded for occasionally taking Ambien, a Xanax like sleeping pill. Took him months to get his medical back. Some docs use antidepressants to treat anxiety and some of these can be approved for short term use. Behavioral therapy might be an option but I don't know how effective it is. You should probably wait for Dr. Bruce to weigh in.
     
  3. Doggtyred

    Doggtyred En-Route

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    I would prescribe a new job if that is an option. This may be an overly simplistic solution, but its worth some tought.

    Taking meds doesn't clear up the underlying stress and the effect it has on your well being, and cardiovascular system. Blood pressure, weight, nutrition, interaction with others.. all of these can be adversely affected by job stress.
     
  4. ScottM

    ScottM Taxi to Parking

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    Something weird there. Ambien is allowed for occasional use (<1-2x per week) and you have to wait 24 hours before flying.

    When it first came out I used it in my travels to deal with the massive jet lag I would get. I had no problem renewing my medical. Eventually I stopped using it because it just did not work anymore and Ted was missing my 2-4 am posts on the PoA. I wonder if your friend was using a lot more than occasionally?
     
  5. ScottM

    ScottM Taxi to Parking

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    IMHO drugs never solve problems. Have you considered other therapies, talking to a counselor, time off, new job?
     
  6. bbchien

    bbchien Touchdown! Greaser!

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    Ambien is not for anxiety.

    There are NO RXs that are acceptable to the FAA for anxiety. If you must take something do so for LESS THAN SIX MONTHS and self ground. Why less than six months? The resultant full metal jacket psych eval that will become necessary for return to service will make you quite anxious.....if the duration was less than six months, the AME can make the issuance call without a psych.

    But for certain, don't just take a "try this you'll feel better" medicine. Uh uhhhh.
     
  7. Gary F

    Gary F Final Approach

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    You got me on this one, and a medical issue at that. It was off of one of the Diamond Aviator's sites. I reviewed the post from last year and he did not actually specify Ambien. I also checked and Ambien is not a benzo type drug, probably why it is OK with the FAA.
    I reported sleeping medication for occasional insomnia on my medical and now I am grounded.
    I checked the AOPA database and benzos including Ativan, Valium and Xanax are not allowed. Buspar is not allowed. As you say Ambien is OK for occasional use after a 24 hr wait. I should have checked first.

    I no longer practice primary care but when I did I avoided treating anxiety with sedatives. Antidepressants are generally preferred but the best thing is to deal with the cause if possible. I discourage anything but rare use of sleeping pills and recommend sleep hygiene measures instead.
    http://www.umm.edu/sleep/sleep_hyg.htm

    Some people have acceptable results from using over the counter melatonin as a sleep aid.
     
    Last edited: Jan 13, 2011
  8. bbchien

    bbchien Touchdown! Greaser!

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    Ambien is for SLEEP, not for any sort of anxiety.

    And like Gary F, I made a change: I only do aviation medicine now :) :)
     
  9. Gary F

    Gary F Final Approach

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    Sorry about the confusion. I did not know about the FAA's rules on antidepressants. I speculated that since they do not allow some sleeping pills they would not approve anti-anxiety meds. I should have waited for the expert. It is important to verify that any med you have been prescribed is OK with the FAA before taking it.
     
  10. Unregistered

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    So say I take Xanax for a month or two and self ground. Do I just need to inofrm the FAA I was on it and now off and get an AME to sign off?
     
  11. Gary F

    Gary F Final Approach

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    I think that you would have to list that doctor visit and diagnosis that resulted in the Xanax prescription and that might lead to some problems. Hopefully Dr. Chien will clarify.
     
  12. Unregistered

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    How about SSRI's? Same thing? What is the procedure after you stop taking them to get your medical back and start flying again?
     
  13. bbchien

    bbchien Touchdown! Greaser!

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    If you're taking it two months at a time repetitively, that is beyond self ground/self certification, you need a full eval. Sigh.
     
  14. Unregistered

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    Ok, I'm am not going to do that then.

    What meds can I take briefly? Say one month or so? I am IR with a real travelling airplane and also use it for work so I can not afford to be grounded very long.
     
  15. Jack Spectre

    Jack Spectre Line Up and Wait

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    I have several friends who took zoloft, xanax, and/or paxil for "panic attacks" and anxiety. They all regretted it later, and had difficulty getting off of them. Maybe there are cases where these drugs work well (I realize my three friends represent a small sample size), but the side effects were pretty scary.

    If I were in the OPs situation, I would exhaust other options first before turning to these drugs.
     
  16. Unregistered

    Unregistered Guest

    I'm a different Unregistered, but in the same situation as the OP I think. Some things are going on at work for me, causing a fair amount of daily anxiety, and it's not a situation that I can easily get out of (I own the company).

    I consulted my MD who suggested that I take Xanax for 30-90 days or so while I work through this period. I've started on the Xanax, and self grounded. The Xanax works really well, and I'm functioning normally.

    My intention is to get off the Xanax, which I am now taking as necessary, after some of the stuff that's going on is over.

    Can I just start flying again in a couple of month and report this situation at my next medical, or do I need to do some kind of interim reporting?

    If so, what do I need to do to keep the FAA happy and get going again? I'm under 40 and have a third class medical. Paradoxically, flying is a great stress reliever for me and I only go up for fun.
     
  17. Unregistered

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    OP here. What are the side effects of Xanax? Are you experiencing any?

    I'd like to know this too.
     
  18. Doggtyred

    Doggtyred En-Route

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    Its addictive/habit forming. Withdrawal can be pretty unpleasant.
     
  19. Unregistered

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    What if you take it sporadically for just 30 days?
     
  20. bbchien

    bbchien Touchdown! Greaser!

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    Unreg #2- if you can show by prescription records that it was only for 30 days, the AME can decide. The question is, however, 18M, the CONDITION for which the Rx occurred.
     
  21. Mike Boehler

    Mike Boehler Pre-takeoff checklist

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    I started Xanax when I quit flying 8 years ago. My doc was a pilot and he specifically asked if I was getting back into it and I said no. But now, 8 years later, I won't get another prescription in fear of the above advice, as i need a C3 and this is a def. show stopper.

    I know LOTS of people that are taking this stuff without any side effects nor dependency.

    I would get a 30 tab prescription of 1 MG and it would last a year. I took it while commercial flying (sitting in the back would freak me out and make me sick) this helped.

    IMO there should not be a blanket thrown on all psych meds.

    I've been to 2 "talk therapist" and they both sucked.

    As far as finding a new job as offered by above, this is a little bit of a "pie in the sky" attitude and while it makes perfect sense, I would suggest that it is much easier to type this advice than it is to practice it.

    Thanks to Bruce the Doc for his advice here. I was going to ask a similar question.

    One more thing. I couldn't get a simple term life policy for 200K as long as this prescription was on my record. I waited 2 years after my last prescription and I got my Term Life. Just food for thought before saying yes to the doc.
     
  22. bbchien

    bbchien Touchdown! Greaser!

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    In 17 of 20 fatals "illegal drugs in the blood" accidents reported by Dr. Akin in 2003 (AAM03/7, CAMI), Xanax and xanax like meds were found in the blood. this prohibition is not going away.
     
  23. RJM62

    RJM62 Touchdown! Greaser!

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    What about something like St. John's Wort?

    -Rich
     
  24. SCCutler

    SCCutler Administrator Management Council Member PoA Supporter

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    Best thing I ever found for depression is a series of aggressive workouts.
     
  25. Gary F

    Gary F Final Approach

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    Disclaimer: I am not a psychiatrist.

    I do not know how the FAA treats herbal remedies. I doubt that they would need to be listed.

    St. John's wort is an over the counter remedy for the treatment of mild depression. I believe that it was more popular a few years ago. I do not know why it appears to be less frequently used now. I suspect it has been replaced by prescription antidepressants which can be as cheap as $4 per month. A review article in the New England Journal of Medicine in 2000 briefly mentioned it.

    Herbal Remedies

    Hypericum perforatum (St. John's wort), an herbal remedy marketed as a dietary supplement, appears to be more effective than placebo and as effective as low-dose tricyclic antidepressants for the treatment of mild depression.58,59 Side effects are infrequent


    http://www.nejm.org/doi/full/10.1056/NEJM200012283432607

    I have seen references to other studies but don't have the time to hunt all of them down.
    http://www.sciencedaily.com/releases/2008/10/081007192435.htm

    St. John's wort has many drug interactions so I would ask a pharmacist if it is a problem with anything you are currently taking.
    http://www.rxlist.com/script/main/art.asp?articlekey=96348&page=3#Interactions

    Pilots often want to self treat to avoid issues with obtaining a medical certificate. This can be a big problem if treatment for certain medical conditions is delayed or avoided entirely. If suicidal ideation is present a prompt medical evaluation is necessary as this can be a symptom of major depression.
     
    Last edited: Jan 23, 2011
  26. Gary F

    Gary F Final Approach

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    I have read that regular exercise can be helpful in improving mood. I also recommend abstaining from alcohol and recreational drugs.
     
  27. Hey, this is Unreg #2 here (this is going to get confusing - so I'll just share that my name is John).

    I'm on a light dosage of Xanax (0.5 mg tablets, take as needed). I'm combining this treatment with informal psychotherapy/life management counseling and frequent exercise. I'm taking 1 to 3 of the Xanax tablets per day (the doc approved me for up to 3 per day)

    This is definitely situational and work related - e.g. my company has been on the edge of going under for the past 6 months, and I've put my life into this thing over the past few years. It looked like we were going to be ok, and then a major client fell apart with an incredibly large past due amount owed to us, so now there are lawsuits going on to try and claim what's ours. Tie into all of this that I bought a house and got married in the past few months. There's just a lot going on, that will eventually dissipate.

    So the "underlying" condition the doc is reporting is that "he doesn't know yet", and we're trying Xanax to resolve it. It seems to allow me to function very well at work when I take it and overcome the tendency to want to "panic" and be unproductive.

    I guess my question is this: do I need to talk to my AME as soon as I'm past this stuff and ready to fly again to get some kind of clearance, or should I just start flying again and report all of this when my medical is up for renewal? I've got another couple of years on this medical, so I'd rather not go in anytime soon unless I need to.

    My side effects/symptoms are nil. I feel completely alert, capable of making quick decisions, and other that the situational anxiety, perfectly healthy.
     
  28. flyingcheesehead

    flyingcheesehead Touchdown! Greaser!

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    FTFY. ;)
     
  29. PresandCeo

    PresandCeo Filing Flight Plan

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    Unreg #2 just registered as "PresAndCeo", will post under that in the future. (Did it so I'd receive email updates)
     
  30. gprellwitz

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    Welcome!
     
  31. RJM62

    RJM62 Touchdown! Greaser!

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    Thanks, Gary. Also by the way of disclaimer, I am not depressed. If anything, I tend to live on the manic edge of life. :goofy:But I've known a lot of people who found SJW to be a lifesaver.

    -Rich
     
  32. Gary F

    Gary F Final Approach

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    I did not assume that you were. I thought it was a good general medical question so I decided to give a reply to anybody who might be interested.
     
  33. Doggtyred

    Doggtyred En-Route

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    Im much less concerned about a diagnosis of major depression in this instance. I'm MUCH MUCH more concerned about suicide by plane and it impacting more than just the pilot.
     
  34. Gary F

    Gary F Final Approach

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    This is why the FAA does not want people who have major depression flying airplanes. Most people who are suicidal have major depression or another psychiatric diagnosis. That's why suicidal ideation is an emergency requiring an immediate medical evaluation. The good news is that only a minority of people who contemplate suicide actually go through with it. Suicide by airplane has been well documented.

    http://charlesorourke.com/suicide-by-airplane/

    A good basic medical review on the subject. http://www.aafp.org/afp/990315ap/1500.html
     
    Last edited: Jan 23, 2011
  35. PresandCeo

    PresandCeo Filing Flight Plan

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    Thanks! Good to be here!
     
  36. Jeanie

    Jeanie Pattern Altitude

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    there is an herbal supplement called 'seredyn' that has been shown to be beneficial for anxiety - you can look it up online www.seredyn.com

    another thing that may help you w/ your anxiety is meditation - I teach meditation so if you want more info just PM me and we'll talk about it
     
  37. Doggtyred

    Doggtyred En-Route

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    So.. what happens when you suddenly stop taking it or take more than the recommended doses? And what are the interactions with other meds and foods?
     
  38. woodstock

    woodstock Final Approach

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    Have you considered talking to an attorney about the difficult issues - IE if it is something your boss is creating, for instance, maybe you can get relief. Maybe even moved to another boss. (I'm just throwing ideas out there).
     
  39. RJM62

    RJM62 Touchdown! Greaser!

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    Good grief...

    I guess it shouldn't be surprising, though. When I was an EMS volunteer, I suspected that some of the single-car, single-occupant crashes we responded to were suicides.

    -Rich
     
  40. Jeanie

    Jeanie Pattern Altitude

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    ~~~ nothing happens when you don't take it other than you might feel anxious - it is a take on an as needed basis kinda thing - it's a "dietary supplement" not a drug.