Renewing Medicals

[MBA06]

I'm sorry if this questions has been asked before, but I just wanted some clarification. I got my PPL about 5 years ago. Due to some challenges, I needed to start taking an SSRI and grounded myself. I never informed the FAA, but I now realize that may have been a mistake.I took the medicine for a couple of years but have been off it for several months now and am doing great. I want to renew my medical and get additional ratings. What do I need to disclose to the FAA at this point. Thanks.

[My Flight Surgeon]

1) Be off the medication for 6 months.
2) Get copies of all of the medical records related to the use of these drugs.
3) Get a current psychiatric evaluation (by a Board Certified Psychiatrist)
4) Submit all of these to the FAA with a request for approval for a medical certificate.

[MBA06]

Thanks Dr. Forred,
One last question. What does all medical records consist of? Does the FAA need to see my actual charts, etc?

[My Flight Surgeon]

Yes, that is exactly what they want to see.

[TXaviator]

im curious if you have any other insight into the FAA's position on depression and medications...

it would seem that by grounding pilots who acknowledge treating their depression, that it would create a very dont-ask-dont-tell situation with pilots who may benefit from antidepressants, but instead do not seek treatment....

what are your feelings and thoughts on this?

[My Flight Surgeon]

You are probably right but they view this as a safety issue. I would tend to agree with them - depression can be very dangerous. The real problems in depression are the lack of concentration and focus. This detracts from the important tasks in the cockpit. The other issue is the side effects of antidepressants - specifically increased incidence of suicide with some of the SSRI agents. These are listed here:

• suicidality
• depression, worsening
• serotonin syndrome
• withdrawal syndrome
• mania
• seizures
• hyponatremia
• SIADH

Part of the issue is that if a depressed pilot goes to fly, has an accident which is ALWAYS on CNN, the local congressman calls the FAA and asks what they are doing for the safety of the flying public. A real sticky wicket for a governmental agency who relies on congressional approval for funding and authority. Remember, currently the decision power as to medical regulation lies with the Federal Air Surgeon. A few upset congressmen could write changes into law and there would be no such animal as Special Issuance at all.

The FAA is considering allowing some pilots to fly on Special Issuance using SSRI anti-depressants but there will be very strict monitoring in the first few years until they get enough data to establish what the proper monitoring criteria will be.

[TXaviator]

Originally Posted by My Flight Surgeon

You are probably right but they view this as a safety issue. I would tend to agree with them - depression can be very dangerous. The real problems in depression are the lack of concentration and focus. This detracts from the important tasks in the cockpit. The other issue is the side effects of antidepressants - specifically increased incidence of suicide with some of the SSRI agents. These are listed here:

• suicidality
• depression, worsening
• serotonin syndrome
• withdrawal syndrome
• mania
• seizures
• hyponatremia
• SIADH

Part of the issue is that if a depressed pilot goes to fly, has an accident which is ALWAYS on CNN, the local congressman calls the FAA and asks what they are doing for the safety of the flying public. A real sticky wicket for a governmental agency who relies on congressional approval for funding and authority. Remember, currently the decision power as to medical regulation lies with the Federal Air Surgeon. A few upset congressmen could write changes into law and there would be no such animal as Special Issuance at all.

The FAA is considering allowing some pilots to fly on Special Issuance using SSRI anti-depressants but there will be very strict monitoring in the first few years until they get enough data to establish what the proper monitoring criteria will be.

I suppose this only goes to show how little we still understand the fine nuances of the brain and consciousness, I am sure 100 years from now we will look back and marvel at how primitive our medicine and thinking about the brain is!!

Depression can be very dangerous (and sad), but so can untreated depression.

[My Flight Surgeon]

It is amazing when I look back at medical school - we did not have CT scans or MRI's. Pretty primitive by today's standards and that was a mere 40 years ago.