Your thoughts/opinions on my situation; hx depression and ssri use

Gordon Gibbons

Gordon Gibbons

Filing Flight Plan
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Hey guys, I could really use some advice or information from those in the know. Here's the Reader's Digest version:

47 years old, been on Wellbutrin for depression for about 12 years, been on Prozac for about 6 years in combination. I have been completely sober for 13 years.

I would now like to get my PPL, but I know Wellbutrin is not allowed and Prozac requires a special issuance for continued use (correct me if I'm wrong). Discontinuance of these meds could allow me to get my medical.

After discussions with my primary care Dr, she is willing to ween me off everything this fall to see how I do off these meds. If I handle it well, she would report to our local AME that I've been off these meds for however long (60 days? 90?) and have been doing well.

Assuming this scenario becomes reality, do you think I'll be able to get medical approval? The nurse at the AME's office believed I'd be ok at that point, but seems the more I read, the less certain I feel about it. Could the AME say absolutely not, hx of depression, long term medication use for depression, not going to issue it no matter what.

Brutal honesty is encouraged. Thanks in advance, Gordon
 
You really need to consult with B. Chien. It’s not as easy as just getting off the meds. Especially if you have a diagnosis and you have been on them so long.


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Tommar98 said:
You really need to consult with B. Chien. It’s not as easy as just getting off the meds. Especially if you have a diagnosis and you have been on them so long.


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I see he is the go-to Dr on this topic. Does he regularly help/counsel members here with these type of issues? I don’t want to inconvenience him.
 
Gordon Gibbons said:
I see he is the go-to Dr on this topic. Does he regularly help/counsel members here with these type of issues? I don’t want to inconvenience him.
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Yes.

Another reason he is one of the "go to" doctors for your situation: Dr. Chien is one of the 4 doctors who created the SSRI protocol and successfully gained its acceptance.

You can reach out to him privately by using this link: http://www.aeromedicaldoc.com/how-to-start.html

Be sure to read the instructions on the left. Do note that he will tell you like it is and must be, whether you like what is said or not. And he does not suffer airmen who ask for guidance and then chose to go off on their own tangents. If he says certification is possible, but to obtain it, you must do a particular list of steps, then that is the path to glory. Do those things and only those things.

Do be prepared for some expensive neuropsychological testing. And not just any random testing. It must be conducted in a specific manner, and done by the very few doctors the FAA has approved. Expect to pay for this out of pocket. And also be ready to add to the money budget the cost of travel to these doctors.

Best of luck to you, and keep us in the info loop as appropriate.
 
it would be a full on HIMS case ... and would hang on the HIMS psychiatrist's opinion.
 
AggieMike88 said:
Yes.

Another reason he is one of the "go to" doctors for your situation: Dr. Chien is one of the 4 doctors who created the SSRI protocol and successfully gained its acceptance.

You can reach out to him privately by using this link: http://www.aeromedicaldoc.com/how-to-start.html

Be sure to read the instructions on the left. Do note that he will tell you like it is and must be, whether you like what is said or not. And he does not suffer airmen who ask for guidance and then chose to go off on their own tangents. If he says certification is possible, but to obtain it, you must do a particular list of steps, then that is the path to glory. Do those things and only those things.

Do be prepared for some expensive neuropsychological testing. And not just any random testing. It must be conducted in a specific manner, and done by the very few doctors the FAA has approved. Expect to pay for this out of pocket. And also be ready to add to the money budget the cost of travel to these doctors.

Best of luck to you, and keep us in the info loop as appropriate.
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Very good. Thanks for the post. I’ll contact the Dr.

Thank you all.
 
Gordon...if you discontinue after 12 years (40% of your adult life) you will have a very hard time convincing ANYONE that you do not have “recurrent disease, untreated and unmonitored”. That is ALWAYS denied by FAA.

If you ever had both Wellbutrin and Prozac together, that control technique is known as “amplification”, and is a severity indicator which excludes you from the “on SSRI” pathway.

If what you wrote is borne out by record, you do NOT have a certification path. I have one pending, tied up in DC for 18 mos, in which the HIMS psychiatrist testified that he found no evidence that the business founder who took Celexa for stress for 14 years, ever had ANYTHING. FAA does not like the situation of having been on meds for a very long time” situation” as accurate diagnosis is hard without a good length of observation off meds...e.g. years.

Also, in a dual diagnosis situation (depression+ alcohol), they will insist on rehab...full 4 week rehab.
 
bbchien said:
Gordon...if you discontinue after 12 years (40% of your adult life) you will have a very hard time convincing ANYONE that you do not have “recurrent disease, untreated and unmonitored”. That is ALWAYS denied by FAA.

If you ever had both Wellbutrin and Prozac together, that control technique is known as “amplification”, and is a severity indicator which excludes you from the “on SSRI” pathway.

If what you wrote is borne out by record, you do NOT have a certification path. I have one pending, tied up in DC for 18 mos, in which the HIMS psychiatrist testified that he found no evidence that the business founder who took Celexa for stress for 14 years, ever had ANYTHING. FAA does not like the situation of having been on meds for a very long time” situation” as accurate diagnosis is hard without a good length of observation off meds...e.g. years.

Also, in a dual diagnosis situation (depression+ alcohol), they will insist on rehab...full 4 week rehab.
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Thank you Dr Chien, I sincerely appreciate your input. The more I had read, here and your website, I knew this wasn’t going to happen for me. Many thanks, for your work and your detailed response to my post! Safe travels to you!
 
Gordon Gibbons said:
Thank you Dr Chien, I sincerely appreciate your input. The more I had read, here and your website, I knew this wasn’t going to happen for me. Many thanks, for your work and your detailed response to my post! Safe travels to you!
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Sport pilot, mate! It will cost you less but will limit your travels a little, daytime VFR only and one passenger.

The docs gave you your answer, now go fly anyway!
 
Gordon,

Even if the medical route doesn’t work out, it doesn’t mean you have to be on the sidelines. Check around. There may be a glider club nearby, there may be a CAF wing nearby. Both those places are always looking for volunteers. In the case of gliders, no medical is necessary and you could get instruction. In the case of CAF you will be around a lot of interesting people and can hitch a ride now and then. There are a lot of pilots that have lost the their medical that still find ways to get in the air, you have to be creative.

Good luck to you!
 
Matthew said:
Gordon,

Even if the medical route doesn’t work out, it doesn’t mean you have to be on the sidelines. Check around. There may be a glider club nearby, there may be a CAF wing nearby. Both those places are always looking for volunteers. In the case of gliders, no medical is necessary and you could get instruction. In the case of CAF you will be around a lot of interesting people and can hitch a ride now and then. There are a lot of pilots that have lost the their medical that still find ways to get in the air, you have to be creative.

Good luck to you!
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Hmmm, that’s interesting... I rode in a glider years ago and it was pretty amazing. German pilot, North Shore of Oahu, turned a scenic flight into an acrobatic one! That was fun.
 
Gordon Gibbons said:
Hmmm, that’s interesting... I rode in a glider years ago and it was pretty amazing. German pilot, North Shore of Oahu, turned a scenic flight into an acrobatic one! That was fun.
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Not sure where you are, but here’s a list of places.

Edit:

Forgot to include the link!

https://www.ssa.org/WhereToFly
 
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If in the states, I suggest you explore Sport Pilot and Glider. Both awesome fun and have you as pilot in command solo or with a passenger.

The Sport Pilot /LSA planes are very capable and fun, depending on how much $$$ you want to invest.
 
You need to find a friend to go flying with. Just getting up is nice.
 
Check out a 7ac Champ, j-3 Cub or maybe a Sling S-2 or the Bushcat.

All great options for different reasons. Champ and J-3 are 75 year-Old classic planes. No electric system or radios. Low & slow but tandem seating (one in front of the other vs side by side) and you fly with a stick. Nostalgic.

Sling is sexy new composite styling. 120 knots with modern avionics. Bushcat is an affordable new build. Modern avionics, great STOL characteristics but slow. 95 knots on 120 hp.
 
Half Fast said:
@Gordon Gibbons what’s your mission? What sort of flying do you want to do?
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Well, I wanted to fly for Cape Air as a second career. I’ve been in law enforcement for 25 years, I have 7 to go until I will retire at 55. I had hoped I could use these 7 years to build time towards that second career.
 
Gordon Gibbons said:
Well, I wanted to fly for Cape Air as a second career. I’ve been in law enforcement for 25 years, I have 7 to go until I will retire at 55. I had hoped I could use these 7 years to build time towards that second career.
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Sounds like that's going to be nearly impossible. If you still want to fly for fun, however, Sport Pilot could be a great option.
 
Half Fast said:
Sounds like that's going to be nearly impossible. If you still want to fly for fun, however, Sport Pilot could be a great option.
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Yes unfortunately that won’t be happening.

I find irony in that 15 years ago when I was actively alcoholic and in the throes of depression, I would have had no issues getting a medical clearance. Today I have never been better and I have no chance of flying.
 
Gordon Gibbons said:
Yes unfortunately that won’t be happening.

I find irony in that 15 years ago when I was actively alcoholic and in the throes of depression, I would have had no issues getting a medical clearance. Today I have never been better and I have no chance of flying.
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You may find irony in the thought; however, it is not true.
 
Gordon Gibbons said:
Yes unfortunately that won’t be happening.

I find irony in that 15 years ago when I was actively alcoholic and in the throes of depression, I would have had no issues getting a medical clearance. Today I have never been better and I have no chance of flying.
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No exactly true about 15 years ago. And for any revenue certification the past depression investigation will reveal the alcohol issue- and then you're going to have to document 15 years of complete abstinence, survive HIMS level evaluation, and perhaps go to rehab.
 
mryan75 said:
You may find irony in the thought; however, it is not true.
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OK. Well clearly I have no understanding of how all of this works. Bottom line is I know it’s not happening for me. Safe travels to all of you.
 
[QUOTE="Hey guys, I could really use some advice or information n[/QUOTE]

Wow, what a nightmare!!! My PCP put me on an SSRI which then failed my medical 2017. I quit the SSRI almost 2 years ago, now how do I get my medical back? That PCP is out of business and I can't get my records. I don't have copies of my MedExpress applications either.
 
Rivet said:
[QUOTE="Hey guys, I could really use some advice or information n
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Wow, what a nightmare!!! My PCP put me on an SSRI which then failed my medical 2017. I quit the SSRI almost 2 years ago, now how do I get my medical back? That PCP is out of business and I can't get my records. I don't have copies of my MedExpress applications either.[/QUOTE]

You might be able to do the SSRI pathway 1. See https://www.faa.gov/about/office_or...am/ame/guide/media/SSRI Decision Path - I.pdf .

Probably best to figure out how to get the records from the practice or a partner that continued the practice. Alternately there is probably some legal procedure for what they do to store records for the legally required interval in your state when completely leaving the business.

Then do a consult with an AME about it. http://tinyurl.com/ame-consult.

You will also likely need 60 days of documented mental health not on the SSRI seeing a provider during that time. May need to be a psychiatrist.
 
Listen to Dr Bruce! He is the expert and tells it the way it is. Save yourself a lot of upset and turmoil.
 
Thank you for the link... This decision path does not cover the typical scenario.. PCP prescribes X, you report X to FAA, and they send you $10,000 worth of testing to complete. From what I see, even if you discontinue, you still need a full team of HIMS doctors and tests??? This is a huge financial nightmare.
Unless I'm mistaken, I don't see any path from "Airman is on SSRI" that leads to "Elects to discontinue" without completing the FAA Certification Aid - SSRI Initial cert/clearance checklist, which HIMS AME is $250 just to consult, and $2600 to perform. (http://atlantaame.com/ ) Not only that, but the AME told me I had to switch to another SSRI, and I would be fine, ("All my delta pilots are on X"... ) at which point the FAA sent the same disqualifying letter.

Jeezzz, I'm just a SEL class 3 medical taking my daughter for a burger!!!!
 
Jeezzz, I'm just a SEL class 3 medical taking my daughter for a burger!!!!
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Yes, the current aeromedical regs are a minefield of gotchas and catch-22s. It costs a lot of money to do a special issuance and so a lot of non-commercial pilots just quit at that point.

I agree with @jonvcaples, get ahold of Dr. Chien at http://aeromedicaldoc.com. His consult on this will probably be one of your best values in aviation.
 
Gordon Gibbons said:
Yes unfortunately that won’t be happening.

I find irony in that 15 years ago when I was actively alcoholic and in the throes of depression, I would have had no issues getting a medical clearance. Today I have never been better and I have no chance of flying.
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Yep. As long as you hadn’t had a DUI, or law enforcement issues and weren’t being treated/diagnosed for the depression you could fly an airliner.

The FAA really knows how to keep the public safe, don’t they. ;)
 
There is good reason for all this. If you’ve been on medication for something for years, you have a real problem or you have a bad doctor. Discontinuing the medication doesn’t solve the problem, it means you now have an untreated problem. So the choices are that you either are untreated or you have a self administered treatment, which you might skip on any particular day.

The only path forward is to prove that there was no problem in the first place, which is what the HIMS evaluation is about.
 
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