Antidepressants

[slysi]

Sadly I have lost my battle to get a medical certificate . I was taking SNRI's which are clearly not allowed for aviation purposes. I went through three months on trying to change to a SSRI that is allowed however the side effects far outweighed any positives. It is very frustrating that I feel 100% on my medication but am not allowed to fly.

The rules are the rules however and I live in hope that one day the aviation regulators worldwide will recognise that a correctly treated person is not a threat to him/her self or any other person for that matter.

I enjoyed my short time in the air though....there is no better feeling than the freedom of flight.

Fly safe all

[Flymed]

6.4. Disqualifying Conditions
1. Any history of depressive disorder of a severe degree is disqualifying.
2. The following conditions will by virtue of their risk profile exclude a person from obtaining a Certificate of
Aviation-medical fitness:
a. History of psychosis
b. Impairment of arousal
c. History of electro-convulsive therapy
d. Concurrent treatment with multiple antidepressant medications
e. History of multi-agent drug use (prior use of other psychiatric drugs in conjunction with
antidepressant medications)
f. History of discontinuation of acceptable medication and then a subsequent onset of depression.
g. Any other manifestation of mood disorder as specified at the time of promulgation, or at the
discretion of the treating psychiatrist.

These are the disqualifying risk factors identified by SACAA in their protocol. If any of them are present, then there is no going forward.
Medication on the list does not yet include SNRI's, but we did propose the use of SNRI's. For reasons beyond any reasonableness, the SNRI's were not written into the protocol by CAA one sidedly. What I am trying to say is that you can fight them and win the fight if you are not "guilty" of above "offences" and is on one drug (SNRI) alone.
The drug that was cleared very specifically was Cymbalta; if this helps.
Although Valdoxane (different class drug altogether) is not on the list, it will also be a drug favourable with use in aviation. That is if you are up to the fight.

[slysi]

6.4. Disqualifying Conditions
1. Any history of depressive disorder of a severe degree is disqualifying.
2. The following conditions will by virtue of their risk profile exclude a person from obtaining a Certificate of
Aviation-medical fitness:
a. History of psychosis
b. Impairment of arousal
c. History of electro-convulsive therapy
d. Concurrent treatment with multiple antidepressant medications
e. History of multi-agent drug use (prior use of other psychiatric drugs in conjunction with
antidepressant medications)
f. History of discontinuation of acceptable medication and then a subsequent onset of depression.
g. Any other manifestation of mood disorder as specified at the time of promulgation, or at the
discretion of the treating psychiatrist.

These are the disqualifying risk factors identified by SACAA in their protocol. If any of them are present, then there is no going forward.
Medication on the list does not yet include SNRI's, but we did propose the use of SNRI's. For reasons beyond any reasonableness, the SNRI's were not written into the protocol by CAA one sidedly. What I am trying to say is that you can fight them and win the fight if you are not "guilty" of above "offences" and is on one drug (SNRI) alone.
The drug that was cleared very specifically was Cymbalta; if this helps.
Although Valdoxane (different class drug altogether) is not on the list, it will also be a drug favourable with use in aviation. That is if you are up to the fight.

Thanks Flymed

I was on Molipaxin (Trazodone) and Venlor (Venlafaxine). When chatting to the CAA I fully understand why Trazodone is not permitted due to its sedation effects with possible mental impairment as well. However the CAA was quite clear that I needed to come off both! I have successfully stopped the Trazodone and am only taking the Venlafaxine.

Can I fight based on the above? I am always up for a challenge!

[Flymed]

Yes, you can. Your stumbling block will be the fact that you were on two drugs. CAA will insist on a detailed psychiatric report stating very clearly that you are well controlled on one drug alone. They will also ask for a psychological report, and would prefer a neuro-psychology report rather than a general psychology report.
Make sure you give your psychiatrist the CAA protocol (on their website) to guide him in his reporting.

[slysi]

Yes, you can. Your stumbling block will be the fact that you were on two drugs. CAA will insist on a detailed psychiatric report stating very clearly that you are well controlled on one drug alone. They will also ask for a psychological report, and would prefer a neuro-psychology report rather than a general psychology report.
Make sure you give your psychiatrist the CAA protocol (on their website) to guide him in his reporting.

Who can I speak to at the CAA?

[Flymed]

Yes, you can. Your stumbling block will be the fact that you were on two drugs. CAA will insist on a detailed psychiatric report stating very clearly that you are well controlled on one drug alone. They will also ask for a psychological report, and would prefer a neuro-psychology report rather than a general psychology report.
Make sure you give your psychiatrist the CAA protocol (on their website) to guide him in his reporting.

Who can I speak to at the CAA?

Eish

[slysi]

Yes, you can. Your stumbling block will be the fact that you were on two drugs. CAA will insist on a detailed psychiatric report stating very clearly that you are well controlled on one drug alone. They will also ask for a psychological report, and would prefer a neuro-psychology report rather than a general psychology report.
Make sure you give your psychiatrist the CAA protocol (on their website) to guide him in his reporting.

Who can I speak to at the CAA?

Eish

That person is not listed on their website

[crazydoc]

he must be

[Flymed]

he must be

She is

[Mauler]

The use of specific SSRI antidepressants is permitted subject to some conditions. Other antidepressants, such as SNRIs are not permitted.

The problem is that CAA sees the medication as indicative of the underlying disorder for which it is normally prescribed. SNRIs are typically prescribed for major depressive disorder, which is a big no-no - although there are a number of other lesser conditions for which they are also prescribed.

Bear in mind that it is not just the effects or side-effects of a drug which could ground you either temporarily or permanently.

One big problem is that GPs often tend to prescribe heavy medicine for minor ailments and around 20% of medications are prescribed "off-label" - that is for conditions for which the medication was never approved. At AOPA we have come across a number of instances where GPs prescribed medication solely intended to treat epilepsy for minor problems like motion sickness or the effects of a temporary ear infection. CAA is unlikely to look past the epilepsy - at least not after a long period of grounding and observation. Other drugs like Concerta/Ritalin are routinely prescribed for helping people study for exams etc, when the approved uses may be much more serious, such as narcolepsy.

If your local doc writes you a script for something minor or temporary, you would be well-advised to investigate the drug further before using it. It may be worth getting getting another medical opinion if it is used for any seriously debilitiating conditions. Also, there is a lot info available on the internet which will help you check for any of these concerns.

[Flymed]

The use of specific SSRI antidepressants is permitted subject to some conditions. Other antidepressants, such as SNRIs are not permitted.

The problem is that CAA sees the medication as indicative of the underlying disorder for which it is normally prescribed. SNRIs are typically prescribed for major depressive disorder, which is a big no-no - although there are a number of other lesser conditions for which they are also prescribed.

Bear in mind that it is not just the effects or side-effects of a drug which could ground you either temporarily or permanently.

One big problem is that GPs often tend to prescribe heavy medicine for minor ailments and around 20% of medications are prescribed "off-label" - that is for conditions for which the medication was never approved. At AOPA we have come across a number of instances where GPs prescribed medication solely intended to treat epilepsy for minor problems like motion sickness or the effects of a temporary ear infection. CAA is unlikely to look past the epilepsy - at least not after a long period of grounding and observation. Other drugs like Concerta/Ritalin are routinely prescribed for helping people study for exams etc, when the approved uses may be much more serious, such as narcolepsy.

If your local doc writes you a script for something minor or temporary, you would be well-advised to investigate the drug further before using it. It may be worth getting getting another medical opinion if it is used for any seriously debilitiating conditions. Also, there is a lot info available on the internet which will help you check for any of these concerns.

Careful now!
Please read my previous comments on SNRI's.
GP's are not as illiterate as you would like to think. A fair amount of GP's are more qualified and and higher qualified than most specialists. The GP must maintain a knowledge-base covering all medical and even other subjects, whereas the specialist does not.
Off label does not mean that the medication is not intended for some use; it only means that the medication is not registered for whatever use in the specific country where the registration is applicable; it may be registered for the same use in another country.
Some epilepsy medications are very effective for use in motion sickness situations, and CAA's inability to understand clinical medicine should not now become the real clinician's problem.
A second opinion may just as well be the wrong opinion.
The methylphenidate argument is partly true, and may even be the correct thing to do. Allow the doctor to decide if narcolepsy or any other condition applies; he/she is trained to make the diagnosis. Once again, CAA must up their clinical skills. So by the way, methylphenidate's relative risk is far less that what the popular gossip allows for.

Be very, very cautious of Professor Google. If you use the internet source of wisdom, make sure you have the appropriate wisdom to distinguish truth from fallacy.

If you have developed a trusting and respected relationship with your doctor, then stick to him. He will not intentionally or otherwise harm you, and is always in the best possible position to assess your needs relative to the doctor that does not know you.

[slysi]

Well in closing, the CAA would not budge on their decision. I had to quit flying....

[Horace Blok]

Well in closing, the CAA would not budge on their decision. I had to quit flying....

I so wish the outcome was different . . . . .Its better to have tried and lost than not to have tried at all.

Take care Squire.

[DreamAviator]

I replied on the topic of ADHD. I am not a psychiatrist I hold a BA degree in Behavioral counseling. Again people are quick to label other people, I am not going to go into to much detail again due to space and to much information. A few questions though, why are you labeled as struggling with depression? Also which type are you "diagnosed" with? You don't have to answer it on this forum, I have a Facebook page called " Hope for my life" and my e mail address is jouanker@gmail.com Please feel free to contact me, I would love to see if I could be of any help. No charge.

[Horace Blok]

Slysi - inquisitively - status quo?? Good of you DreamAviator.