Dr.DTW
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Psychotropic Drugs And Piloting

Wed May 30, 2007 8:40 am

Hello everyone:

I'm a psychiatrist in Michigan, and I'm giving a brief presentation tomorrow on the the FAA's position regarding the use of psychotropic (psychiatric) drugs in prospective pilots.

Its my understanding the FAA essentially does not permit the use of any psychoactive medications, including anti-depressants. If an applicant lists such medications on his application, this is enough reason for denial.

I'm hoping that some of you can shed additional light on this topic, and possibly share some stories, that may be of interest and help. Your personal viewpoints will be appreciated.

Also, other than Egypt Air 990, have there been any other instances of pilot suicide-homicide??

Thanks!!!
Dr.DTW
 
airfoilsguy
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RE: Psychotropic Drugs And Piloting

Wed May 30, 2007 8:55 am

Your a doctor and are giving a presentation tomorrow and haven't done any research yet? Your now going to use information gleamed on A-Net in a medical presentation? I am sorry but I have to raise my bullshit flag on this one, but I will play along anyway because I have nothing better to do.


A Russian Air Force engineer stole the aircraft at the Kubinka AFB to commit suicide. The pilot kept circling the city at 300-2000 feet altitude. The aircraft crashed when there was no more fuel left.

http://aviation-safety.net/database/record.php?id=19940713-0


The accident was said to have been caused by the captain disconnecting the autopilot and directing the aircraft to the ground deliberately.

http://aviation-safety.net/database/record.php?id=19940821-1
It's not a near miss it's a near hit!!
 
pilotpip
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RE: Psychotropic Drugs And Piloting

Wed May 30, 2007 9:11 am

There was the kid in Miami a couple years ago that was on one of the psychotropic drugs that are on the banned list, but I can't recall which one. It was pretty highly publisized because he put a cessna in an office building and the cops found letters pledging his alegiance to Bin Ladin.

As an instructor, I'm seeing more and more kids start training and have to stop when it comes time to get their medical because they were placed on ridalin. Getting a medical when this happens usually takes a battery of psychological tests, a lengthy "dry" time off the drug and over a year of beaurocratic red tape.
DMI
 
OB1504
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RE: Psychotropic Drugs And Piloting

Wed May 30, 2007 9:16 am

Quoting Pilotpip (Reply 2):
There was the kid in Miami a couple years ago that was on one of the psychotropic drugs that are on the banned list, but I can't recall which one. It was pretty highly publisized because he put a cessna in an office building and the cops found letters pledging his alegiance to Bin Ladin.

I think this happened in Tampa. IIRC, the pilot was an A.net member.

Edit: The pilot was 15-year-old Charles Bishop, and he flew a Cessna into the Bank of America Plaza in Tampa. He was on Accutane for acne, which can cause psychological side effects.
Tampa Crash Pilot "a Bin Laden Supporter" (by Jiml1126 Jan 6 2002 in Civil Aviation) Cessna Skyscraper Crash - Pilot Was Member (by Administrator Jan 8 2002 in Civil Aviation) Tampa Cessna Crash Caused By Acne Medication? (by B744 Apr 16 2002 in Civil Aviation)

[Edited 2007-05-30 02:24:24]
 
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falstaff
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RE: Psychotropic Drugs And Piloting

Wed May 30, 2007 9:34 am

Quoting Pilotpip (Reply 2):
. It was pretty highly publisized because he put a cessna in an office building and the cops found letters pledging his alegiance to Bin Ladin.

That guy was looney to begin with. Drugs like Prozac and Ritilin don't make you want to do things like that, they keep people from doing things like that! What if the person was just off his rocker and never took even so much as an asprin. Would that make it ok?

I was denied a medical because I had been on Prozac at one point in my life and I was honest about it. I should have lied and I would not have been denied. I was no longer taking the drug at the time of the exam. The FAA still made me wait. I was given prozac because when I stopped smoking I started to suffer from anxiety attacks. I just kept taking it because I never felt I had a reason to stop. I have been off of it for a long while now and I have not had any anxiety attacks and I don't want to smoke either.

Quoting Pilotpip (Reply 2):
when it comes time to get their medical because they were placed on ridalin

The FAA really needs to lighten up some of its medication restrictions. Today there are more and more pills treating us that years ago there was no treatment for. Also many conditions today that once required being hospitalized (I am not talking about a mental hospital) can be treated with a variety of medications.

Example. Lets say some guy is suffering from depression. A doctor gives said person an antidepressant. The person feels fantastic and his life is all roses. If he tried to get a medical he would be denied. However if that same person never got treatment for his depression and able to pass his physical he could get his medical no problem. I would think the FAA would rather have a person in the cockpit who is being medicated and is ok than the mystery of wondering if that person is going without treatment just so they can continue to fly.

The FAA should not have a blanket policy on any drug and they should talk with the prescribing doctor as to what is really going. Many drugs today are used for things that are "off label" My ground school instructor told me many stories about pilots he knows ( some of whom are ATPs) who avoid going to the doctor at all costs and will only go under an assumed name and pay cash. When pilots have to do things like that to keep flying something needs to be done at the FAA.
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falstaff
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RE: Psychotropic Drugs And Piloting

Wed May 30, 2007 9:37 am

Quoting OB1504 (Reply 3):
He was on Accutane for acne, which can cause psychological side effects.

That stuff can be harsh. I had a friend in college who suffered liver damage from Accutane.

Nothing like clearing up a bad case of zits by killing your liver and wrecking your mind.  Yeah sure
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skibum9
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RE: Psychotropic Drugs And Piloting

Wed May 30, 2007 9:51 am

Quoting Pilotpip (Reply 2):
As an instructor, I'm seeing more and more kids start training and have to stop when it comes time to get their medical because they were placed on ridalin. Getting a medical when this happens usually takes a battery of psychological tests, a lengthy "dry" time off the drug and over a year of beaurocratic red tape.

It is not only kids, but adults who have been or are being treated for conditions such as ADD or ADHD. I know of one person who is in his thirties who has been dry for some time now and who has completed the tests and he still is not getting a straight answer from the FAA. Everyone he talks to gives him a different response. One even told him that being diagnosed with an issue like ADD is reason enough to deny a medical, which 1) is not in the F.A.R.s, and 2) there are different degrees of ADD, ranging from very mild to severe. The FARs only state that the medicine is banned, not the condition. The FAA needs to not only get its act together so that everyone conforms and can exlain the policy to applicants, but also should re-evaluate the policy. Pilots in other countries can use some of the drugs and they have been deemed safe by organizations like the JAA.

Quoting Falstaff (Reply 4):
The FAA should not have a blanket policy on any drug and they should talk with the prescribing doctor as to what is really going. Many drugs today are used for things that are "off label" My ground school instructor told me many stories about pilots he knows ( some of whom are ATPs) who avoid going to the doctor at all costs and will only go under an assumed name and pay cash. When pilots have to do things like that to keep flying something needs to be done at the FAA.

There are also many pilots that go to one doctor to get their prescriptions filled and then lie to their AME to continue flying. I have heard many stories of pilots flying around on Ridilin or Concerta, even airline guy.
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Dr.DTW
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RE: Psychotropic Drugs And Piloting

Wed May 30, 2007 10:13 am

Airfoilsguy:

I can assure you I'm not B-S'ing you. I'm a senior psychiatry resident at the University of Michigan Medical Center, in Ann Arbor. We're doing informal "talks" tomorrow in a group format. This is not a primary research paper, which is what you may have been thinking. The purpose of the discussion is just to stimulate ideas, and introduce people to the issue, not to formally present data or give recommendations.

Thanks for your info, nonetheless.

Ed.
 
luisca
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RE: Psychotropic Drugs And Piloting

Wed May 30, 2007 10:21 am

Quoting Falstaff (Reply 5):
Nothing like clearing up a bad case of zits by killing your liver and wrecking your mind.

For some its the only thing that will help, and Acne can cause severe emotional strain on people. Its not just an aesthetics thing, it affects self esteem.
If it ain't Boeing (or Embraer ;-)) I ain't Going!
 
georgiaame
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RE: Psychotropic Drugs And Piloting

Wed May 30, 2007 10:44 am

I have to agree with airfoilsguy on this one. Be that as it may, and professional courtesy being what it is, any and all psychotropic meds are forbidden. Period. They are semi-automatic disqualifications, and all warrent deferral to Ok City for approval for medical certification. This includes Zyban/bupropion for smoking cessation, SSRIs, anti psychotics, etc.

You can fly with a psychiatric HISTORY, BUT, and it is one very big but, the FAA wants total and complete psychiatric records (not the easiest things to obtain), regarding the patient's history, family history, diagnosis, drugs used in the past, side effects, benefits, prognosis. Psychiatric history includes ADD or ADHD and any history of Ritalin/stratera usage. The use of SSRIs to treat PMS is equally disqualifying. The use of trazadone for sleep is disqualifying. I think you get the point. In order to be considered for possible issuance of a medical certificate, the FAA will want complete, current psychological testing of the patient. And it doesn't matter if the problem is fully resolved on a diagnosis made 10 years earlier, they will want the old records, plus a full current evaluation.

At that point they may issue a medical certificate.
"Trust, but verify!" An old Russian proverb, quoted often by a modern American hero
 
graphic
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RE: Psychotropic Drugs And Piloting

Wed May 30, 2007 10:56 am

How can pilots not be depressed when the official FAA policy is "we're not happy until you're not happy?"
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Pu752
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RE: Psychotropic Drugs And Piloting

Wed May 30, 2007 11:05 am

Quoting Dr.DTW (Thread starter):
Also, other than Egypt Air 990, have there been any other instances of pilot suicide-homicide??

Silk Air 185 was similar to Egypt Air 990, but we may never know exactly what happend, if pilot suicide or mechanical problems.
 
Flighty
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RE: Psychotropic Drugs And Piloting

Wed May 30, 2007 11:17 am

This is kind of funny since the US military issues amphetamines like Ritalin to its longhaul pilots to help them fly SAFER.
 
YHMYYZspotter
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RE: Psychotropic Drugs And Piloting

Wed May 30, 2007 12:25 pm

Quoting Falstaff (Reply 4):
Example. Lets say some guy is suffering from depression. A doctor gives said person an antidepressant. The person feels fantastic and his life is all roses. If he tried to get a medical he would be denied. However if that same person never got treatment for his depression and able to pass his physical he could get his medical no problem. I would think the FAA would rather have a person in the cockpit who is being medicated and is ok than the mystery of wondering if that person is going without treatment just so they can continue to fly.

I've always wondered this too. If you loved to fly and wanted to learn but knew you may be feeling depressed and need treatment. Why go get treatment if it is going to ruin your dream of flying.

Doesnt make sense. Wouldnt they want depressed pilots flying that ARE getting treatments rather than pilots flying around all depressed just because they can pass the medical? Is there nothing controlling this?
 
Analog
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RE: Psychotropic Drugs And Piloting

Wed May 30, 2007 12:28 pm

Quoting Flighty (Reply 12):
This is kind of funny since the US military issues amphetamines like Ritalin to its longhaul pilots to help them fly SAFER.

So can pilots (or anyone else) issued Go Pills ever get medicals after they leave the military? If the FAA is consistent with their logic, the answer should be no.

Go Pills (not Ritalin, but, until recently, dextroamphetamine, IIRC) are only approved to treat ADHD & narcolepsy. Therefore anyone issued these pills must have one of those conditions, and will have them forever, and therefore must be denied a medical. This is the FAA's logic with civilians, so shouldn't it apply to ex-military people too? (please note that this post may contain trace amounts of sarcasm)
 
n710ps
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RE: Psychotropic Drugs And Piloting

Wed May 30, 2007 12:30 pm

I think the point that the poster is trying to get across is what is YOUR stance on these things. I am sure that he has plenty of reserch and data to back up his presentation.
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n710ps
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RE: Psychotropic Drugs And Piloting

Wed May 30, 2007 12:33 pm

And also to add to this being a pilot. I agree with the F.A.A. ban FOR THE MOST PARTbecause there are too many chemichal diffrences and variables to deal with from person to person on medications. Medications are for chem imbalance issues and because of this the reaction and such will be variable from person to person. It is smarter to just make a blanket rule and than based on research and development grandfather certain ones in.

[Edited 2007-05-30 06:04:09]
There is plenty of room for Gods animals, right next to the mashed potatoes!
 
Analog
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RE: Psychotropic Drugs And Piloting

Wed May 30, 2007 12:58 pm

Quoting N710PS (Reply 16):
And also to add to this being a pilot. I agree with the F.A.A. ban FOR THE MOST PARTbecause there are too many chemichal diffrences and variables to deal with from person to person on medications. Medications are for chemichal imbalance issues and because of this the reaction and such will be variable from person to person. It is smarter to just make a blanket rule and than based on research and development grandfather certain ones in.

The problem with this point of view is that it encourages pilots to let psychological conditions go untreated, as seeking treatment would mean loss of a career (not just a job). This is the reality. I'd rather have a pilot be treated and be able to regain his/her medical after an independent evaluation.

Why does the FAA allow ethanol use? Unlike many banned drugs, ethanol is a purely recreational drug. It has lots of negative psychological & physical effects that last longer than the drug itself. There have been many incidents of pilots operating and attempting to operate aircraft while impaired by alcohol. Therefore, shouldn't ethanol use of any kind be grounds for denial of a medical? To me this makes about as much sense as a blanket rule that's not based on research.

How about we screen all pilots for a family history of mental illness, regardless of whether or not they have taken any psychotropic drugs? A family history would be grounds for denial of a medical. To me this makes more sense than denial of a medical for use of Prozac for PMS a decade ago.

I'm not necessarily advocating the two above ideas, just pointing out that they make a lot of sense in comparison to the FAA's current policy.
 
InnocuousFox
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RE: Psychotropic Drugs And Piloting

Wed May 30, 2007 12:59 pm

Quoting Falstaff (Reply 4):
Drugs like Prozac and Ritilin don't make you want to do things like that, they keep people from doing things like that!

That's not entirely true. There are "black box" labels on SSRIs like Prozac - especially with regards to teens. It can make them homicidal or suicidal. Also, if there is a co-morbid diagnosis of bipolar, SSRIs (and SNRIs) can induce mania as well. Manic pilots would not be pleasant at all. Ritalin stimulates dopamine (low dopamine and norepinephrine are suspected causes of ADD/ADHD). Elevated dopamine in the thinking areas of the brain is what causes schizophrenia - including auditory and visual halucinations. So, in theory, if someone was on Ritalin (et al) and didn't need to be (which often happens) it can cause psychotic symptoms.

While I do agree that the FAA rule is a little draconian, I just wanted to clear up your generalized misrepresentation.

Quoting Falstaff (Reply 4):
What if the person was just off his rocker and never took even so much as an asprin. Would that make it ok?

Amen to that. "We would rather you be nuts than medicated."  sarcastic 

Quoting N710PS (Reply 16):
And also to add to this being a pilot. I agree with the F.A.A. ban FOR THE MOST PARTbecause there are too many chemichal diffrences and variables to deal with from person to person on medications. Medications are for chemichal imbalance issues and because of this the reaction and such will be variable from person to person.

By that same token, there are too many chemical differences between people that CAUSE the illness, etc. in the first place... even without medications. Are we to come up with a standard, narrow profile of what your neurotransmitter levels (which we can't directly measure anyway) are before you pass you medical?

The bottom line is, can you operate a freakin' plane without dizziness, blackouts, halucinations, somnolence, etc.?
Dave Mark - Intrinsic Algorithm - Reducing the world to mathematical equations!
 
aa757first
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RE: Psychotropic Drugs And Piloting

Wed May 30, 2007 1:20 pm

Quoting N710PS (Reply 16):
And also to add to this being a pilot. I agree with the F.A.A. ban FOR THE MOST PARTbecause there are too many chemichal diffrences and variables to deal with from person to person on medications. Medications are for chem imbalance issues and because of this the reaction and such will be variable from person to person.

I totally agree with you saying medicines are different from person to person, in psychiatry especially.

However, how many depressed pilots are flying around not doing anything about it because they know they'll have to stop flying if they take some Zoloft? As a passenger, which would you prefer? Would you like a depressed pilot taking a Zoloft, a safe drug, and having periodic appointments with a psychiatrist or would you rather have some depressed and anxious guy flying around with no treatment?

These mental health stigmas run too deep in society and getting rid of archaic policies like this one prevent people from getting the care they need and embarrass them when they do.
 
n186bd
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RE: Psychotropic Drugs And Piloting

Wed May 30, 2007 4:54 pm

First of all, this is my first anutters.net post - I have been following this site for ages and it's been a great help!

As someone who is heavily medicated, I am worried about applying to be a pilot. Physically, I am in great health (vision, hearing, etc). Unfortunately, I was diagnosed with moderate depression my first year of high school. Since then I've taken a plethora of medication, and eventually found out that the depression was caused by anxiety. To me, feeling “compressed” and pressured during many everyday situations (as in eating in a cafeteria) was completely normal. However, as I’ve talked to my doctor, I have noticed a huge difference.

Not to get too personal, but atm I'm on 40mg of Prozac once daily and 1.5 mg of Ativan/Temesta (generic: Lorazepam) three times daily.

To tell you the truth, I link all of this anxiety to being at college/university. I feel that if I were in an environment such as pilot training, I would not need these medicines, as I would be concentrating on such a specific goal.
What I’m trying to say… would it be possible for me to be eligible for flight training? I have been talking to my doctors about the meds, and they do not think I will need them by the time I finish uni/ share the same opinions as me (that I will not need the medication after university).

I would love any feedback that you may have; all these years have made me pretty thick skinned.

regards,
wmb
"To be a sober, plodding, industrious youth was to incur the ridicule of the mass of the students." - James Buchanan
 
md80fanatic
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RE: Psychotropic Drugs And Piloting

Wed May 30, 2007 8:48 pm

Holy Crap!

After reading this thread......I have decided to NEVER fly again. Seriously...thanks for the warning.

Words of advise (to all), quit going to doctors and quit doing all these drugs. Kids never need prozac....it's Dista Products (manufacturer) the doctors that get rich prescribing it who need prozac. Parents - quit sacrificing your kids on the alter of chemicals, be a respectable and honourable parent for God's sake. People get depressed sometimes, and they get acne sometimes.....nothing worth jumping off a building over, or killing your liver or brain. Make a change in your lives and for heaven's sake....wash your face.

 scared 
 
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falstaff
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RE: Psychotropic Drugs And Piloting

Wed May 30, 2007 8:54 pm

Quoting Luisca (Reply 8):
For some its the only thing that will help, and Acne can cause severe emotional strain on people. Its not just an aesthetics thing, it affects self esteem.

I am not saying acne isn't a problem I had problems with it too, when I was a teen. However it is a shame that someone who tried to treat their acne came out with something worse.
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Analog
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RE: Psychotropic Drugs And Piloting

Wed May 30, 2007 9:57 pm

Quoting MD80fanatic (Reply 21):
Words of advise (to all), quit going to doctors and quit doing all these drugs. Kids never need prozac...

The problem is that when parents/doctors decide that their kids need any psychotropic drug, they are essentially denying their child the chance to become a pilot, forever. (That's the impression I get).

That being said, I highly disagree with your post, but that's for another thread/board. BTW: Prozac is now off patent and available as a generic.

Quoting MD80fanatic (Reply 21):

After reading this thread......I have decided to NEVER fly again. Seriously...thanks for the warning.

What's the logic behind that decision?
 
InnocuousFox
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RE: Psychotropic Drugs And Piloting

Thu May 31, 2007 12:20 am

Quoting MD80fanatic (Reply 21):
Words of advise (to all), quit going to doctors and quit doing all these drugs. Kids never need prozac

Diabetics never need insulin...
People with a faulty thyroid never need synthetic thyroid hormones...
Hemophiliacs never need blood clotting agents...
Schizophrenics never need anti-psychotics...
Parkinson's patients never need L-DOPA...

Do you realize that your statement is completely ridiculous? While it IS over diagnosed/prescribed, ADD is, indeed, a measurable malfunction in the bodies creation or absorption of a chemical... just like the above problems - and many others. It is exactly this sort if advise advice that causes incidents like the VaTech massacre to happen. Obviously, someone needed a little tweaking to his malfunctioning chemicals, eh?
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falstaff
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RE: Psychotropic Drugs And Piloting

Thu May 31, 2007 12:25 am

Quoting MD80fanatic (Reply 21):
nothing worth jumping off a building over, or killing your liver or brain. Make a change in your lives and for heaven's sake....wash your face.

Sometimes getting rid of acne isn't all that easy. I am 31 and still have zits on occasion. My dad is 59 and still has zit trouble now and then.

Lots of drugs seem to have dangerous interactions with the liver today. That freaks me out. You need a liver to stay alive.

Quoting Analog (Reply 23):
The problem is that when parents/doctors decide that their kids need any psychotropic drug, they are essentially denying their child the chance to become a pilot, forever. (That's the impression I get).

How many people even know that. If I would have thought about flying ten years ago I would not have had a doctor put me on prozac.

If the FAA keeps denying medicals on certain drugs sooner or later nobody will be left to fly because people are taking more and more drugs.

The FAA doesn't allow many blood pressure drugs. Why not? I would think that blood pressure that is under control would be a non issue.

Quoting InnocuousFox (Reply 18):
The bottom line is, can you operate a freakin' plane without dizziness, blackouts, halucinations, somnolence, etc.?

Took Prozac for years and never had anything like that happen. Side effects can suck, but they don't always happen. A friend of mine had a stroke last year, at 27. The doctors attributed it to her use of a specific type of birth control pill. That type of side effect is very rare, birth control pills are still considered safe. but If FAA worries about possible side effects maybe it should ban every drug out there. It sounds to me like the FAA doesn't give a damn about a pilot's health.

Quoting N186BD (Reply 20):
Not to get too personal, but atm I'm on 40mg of Prozac once daily and 1.5 mg of Ativan/Temesta (generic: Lorazepam) three times daily.

I took 20mg once every other day and they still gave me a hard time.

I wonder how many pilots are out there that need help but refuse to get it because they will lose their career? How about that NW pilot who turned around on the Blue Water Bridge recently. He was drunk, had cocaine on him and led the cops on a chase. He probably had some issues that with professional treatment would get resolved. Instead he went off the deep end and probably lost job/career anyway. We read about pilots showing up drunk and wonder why. They can't seek help so they just try to cope and sometimes life gets the better of them.
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ltbewr
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RE: Psychotropic Drugs And Piloting

Thu May 31, 2007 12:47 am

Perhaps their needs to be a through review of current rules to better balance the use or banning of these and other drugs with certain side affects and the ability to fly. There should also be a limit of how far back in a person's history the FAA can go back to as to the use of such drugs, perhaps 2-5 years.
 
Analog
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RE: Psychotropic Drugs And Piloting

Thu May 31, 2007 1:11 am

Quoting Falstaff (Reply 25):

If the FAA keeps denying medicals on certain drugs sooner or later nobody will be left to fly because people are taking more and more drugs.



Quoting LTBEWR (Reply 26):
Perhaps their needs to be a through review of current rules to better balance the use or banning of these and other drugs with certain side affects and the ability to fly. There should also be a limit of how far back in a person's history the FAA can go back to as to the use of such drugs, perhaps 2-5 years.

I agree. I am very much opposed to the FAA's policy on meds for two reasons:

1. It's arbitrary and unfair to potential pilots. People will argue that safety is more important than potential pilots' feelings. Maybe, but:

2. It encourages denial and hiding of medical conditions that should be treated. If a pilot thinks he/she might be suffering from depression, there is every reason in the world to deny it, both to the FAA and to oneself. This, to me, is contrary to the goal of safety, as well as fairness.

An analogy would be to permanently take aircraft out of service if they have a mechanical design flaw, rather than issuing airworthiness directives to correct problems. Airframe manufacturers and airlines would have a huge motive to conceal any flaws. They would probably start to do that without any mal-intent; it would eventually become part of the culture.
 
adopim88
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RE: Psychotropic Drugs And Piloting

Thu May 31, 2007 1:12 am

Quoting Pilotpip (Reply 2):
I'm seeing more and more kids start training and have to stop when it comes time to get their medical because they were placed on ridalin



Quoting Skibum9 (Reply 6):
It is not only kids, but adults who have been or are being treated for conditions such as ADD or ADHD

I'm just curious, are these kids or adults that are currently on the medication or those that were on it in the past?
Early bird gets the worm, but the second mouse gets the cheese.
 
YHMYYZspotter
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RE: Psychotropic Drugs And Piloting

Thu May 31, 2007 1:23 am

Quoting MD80fanatic (Reply 21):
nothing worth jumping off a building over, or killing your liver or brain. Make a change in your lives and for heaven's sake....wash your face.

That is insulting to anyone who had acne growing up including me. Wash your face? Do you think it is that easy? If you do you are a bloody IDIOT. I am waiting for your apology. It's people like you who drive people to freak out and kill themselves when when have bad acne. Luckily I had support growing up and I am completely clear of acne now.

Anyways I am going to say this right now. I want to get my PPL, I am starting soon. I want to do it bad enough that if I was depressed and needing treatment for it i wouldn't seek treatment if it meant no chance of my PPL. So I guess I would be flying around depressed. Oh well.. thats the rules.
 
jycarlisle
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RE: Psychotropic Drugs And Piloting

Thu May 31, 2007 1:32 am

Quoting Airfoilsguy (Reply 1):
Your now going to use information gleamed on A-Net

Doesn't everyone else in the world?  Embarrassment

Quoting Pilotpip (Reply 2):
As an instructor, I'm seeing more and more kids start training and have to stop when it comes time to get their medical because they were placed on ridalin.

Being that I work with developmentally disabled individuals (to use the politically correct terminology even though I am a totally apolitical correct person), I see the effects of psychotropic medications on various individuals both who need them and those that really do not. I even had a personal friend who just returned from rehab for drug addiction because he abused the several (IMHO misdiagnosed) anti-depressents.

Quite frankly anyone on a psychotropic behind the wheel of a plane would also scare me.

Cheers,
Jeremy Carlisle
"CHANGE IS: CLEAN PLANES AND DIRTY MARTINIS" (DL)
 
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falstaff
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RE: Psychotropic Drugs And Piloting

Thu May 31, 2007 4:11 am

Quoting Jycarlisle (Reply 30):
Quite frankly anyone on a psychotropic behind the wheel of a plane would also scare me.

What scares me is the pilots who have issues and are going untreated. That could be the same a bomb waiting to go off.

Quoting Jycarlisle (Reply 30):
I see the effects of psychotropic medications on various individuals both who need them and those that really do not.

A friend of mine was given Zoloft, by her doctor, when her son died a few years ago. She was feeling depressed and after a couple of years she went off of it and was fine. Maybe she didn't need those pills, but many people do not question their doctor's advice. Not everyone taking psychotropics is a nut case. I think many people would be surprised at the number of people who are taking such drugs and are considered mentally fit.
My mug slaketh over on Falstaff N503
 
georgiaame
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RE: Psychotropic Drugs And Piloting

Thu May 31, 2007 5:02 am

Quoting Analog (Reply 27):
It's arbitrary and unfair to potential pilots



Quoting Analog (Reply 27):
It encourages denial and hiding of medical conditions that should be treated.

Nothing could be further from the truth. It is neither arbitrary, unfair, nor does it encourage denial. A history of depression does not exclude you from the cockpit. BUT you do have to meet minimal FAA standards, just as you have to meet blood pressure or visual standards. Is it arbitrary and unfair that a color blind individual is forbidden to fly at night? Or is is prudent? Meet their criteria, provide them with the documentation that they require to convince them that you are not a danger to yourself or others on the ground, and you get your medical certificate. Play games, you stay on the ground. If you present even a remote danger to someone on the ground, you have no business being in the air, no matter how much you want to be.

Quoting YHMYYZspotter (Reply 29):
I want to do it bad enough that if I was depressed and needing treatment for it i wouldn't seek treatment if it meant no chance of my PPL

A very mature attitude on your part. I certainly would have no problem flying with you, as thunderstorms are building, you are 30 miles out from threshold, you are running low on fuel, your carburetor is acting up, and there is traffic everywhere, and you are starting to bounce in wind shear. This is the very reason we do a mini-mental assessment, and if we feel you have no business in the air, we AMEs do everything we can to advise the FAA of our opinions. Your immaturity in even coming out with a statement like that would be enough for me to defer you to Ok City on the grounds of a personality disorder.
"Trust, but verify!" An old Russian proverb, quoted often by a modern American hero
 
Analog
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RE: Psychotropic Drugs And Piloting

Thu May 31, 2007 5:17 am

Quoting GeorgiaAME (Reply 32):

Nothing could be further from the truth. It is neither arbitrary, unfair, nor does it encourage denial. A history of depression does not exclude you from the cockpit.

So what happens to an airline pilot who goes to a doc, gets a diagnosis of depression, gets a 'script for an SSRI? Does he/she continue to get paid? If not, how long after the pilot claims to be cured until he/she is flying again? Can a pilot maintain a medical while taking an antidepressant that is keeping his/her depression in remission, if supported by multiple medical professionals?

If the answers to these questions are what I think they are (no, a very long time, no), then that would be very strong motivation for any person supporting a family, paying a mortgage, etc. to stay in denial about depression or other illnesses.

Quoting GeorgiaAME (Reply 32):
s it arbitrary and unfair that a color blind individual is forbidden to fly at night? Or is is prudent?

I dunno, but that's permanent. If color blindness were treatable, I'd support allowing people with cured color blindness to fly at night.

Quoting GeorgiaAME (Reply 32):
Your immaturity in even coming out with a statement like that would be enough for me to defer you to Ok City on the grounds of a personality disorder.

See, you'd never hear a statement like that. That's the problem.
 
YHMYYZspotter
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RE: Psychotropic Drugs And Piloting

Thu May 31, 2007 11:03 pm

Quoting GeorgiaAME (Reply 32):
Your immaturity in even coming out with a statement like that would be enough for me to defer you to Ok City on the grounds of a personality disorder.

So you tell me what my options are then? I am done flying for life? You telling me out of the thousands of pilots out there NONE have mental disorders that are being treated? And out of all them how many have them that arent being treated?
 
InnocuousFox
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RE: Psychotropic Drugs And Piloting

Thu May 31, 2007 11:47 pm

Quoting Jycarlisle (Reply 30):
I see the effects of psychotropic medications on various individuals both who need them and those that really do not.

And there are probably a bunch of people you deal with every day that are on various meds... and you have no freakin' clue that they are! THAT is the idiocy of your statement.... only to be exacerbated by this one:

Quoting Jycarlisle (Reply 30):
Quite frankly anyone on a psychotropic behind the wheel of a plane would also scare me.
Dave Mark - Intrinsic Algorithm - Reducing the world to mathematical equations!
 
YHMYYZspotter
Posts: 193
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RE: Psychotropic Drugs And Piloting

Fri Jun 01, 2007 12:41 am

Quoting InnocuousFox (Reply 35):
And there are probably a bunch of people you deal with every day that are on various meds... and you have no freakin' clue that they are! THAT is the idiocy of your statement.... only to be exacerbated by this one:

Of course I agree with you 100%, think about all the people you trust your lives with daily. Your doctor, surgeon, taxi driver, limo driver, bus/coach driver, Air Traffic Control, pilots, accountant (With all your money)... I'm sure there are lots more.
 
Flyboy1108
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RE: Psychotropic Drugs And Piloting

Fri Jun 01, 2007 2:07 am

The FAA and their rules on medications and mental illness I think do have some value, but like has been said numerous times in this thread just because you take Prozac or Adderal or anything of the sort should not be automatic grounds for denial of a medical certificate. I understand that the FAA makes these rules and the AME's make the decision with safety in mind, but how many other professions where people's lives are in the hands of someone else are they allowed to take these kinds of medications? What about bus drivers? I know in PA to get your CDL-A or CDL-B you have to get a physical, but I'm almost certain (please correct me if I'm wrong) that as long as whatever condition you have is under control you can get a CDL. So in that spirit, what's to stop that bus driver from getting on a highway with a bus full of 50 people and running the bus off of the road at 90mph killing the driver and everyone on board? I'm actually surprised no one here thought of that situation. IMO there is absolutely no less danger of that happening then a pilot doing the same thing.
"God is great, beer is good, and people are crazy"
 
Analog
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RE: Psychotropic Drugs And Piloting

Fri Jun 01, 2007 3:32 am

Quoting Flyboy1108 (Reply 37):
but like has been said numerous times in this thread just because you take Prozac or Adderal or anything of the sort should not be automatic grounds for denial of a medical certificate

If I recall correctly, if you take Adderall or another stimulant, the FAA takes that as proof that you have narcolepsy (I think an AME told me this a long time ago), and will therefore never get a medical of any kind.

The case of an adult with ADD taking Adderall, etc. is one of the more absurd cases. Why in the world would you stop someone like that from getting a medical? I could see requiring them to take tests, fly, etc. w/o taking adderall to make sure that they're capable of performing w/o meds, but a ban?
 
georgiaame
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RE: Psychotropic Drugs And Piloting

Fri Jun 01, 2007 5:24 am

Quoting Analog (Reply 33):
So what happens to an airline pilot who goes to a doc, gets a diagnosis of depression, gets a 'script for an SSRI?

He is grounded. Where he stands on disability is up to his employer, not the FAA. Those are the rules.

Let me give you a small story, true story. About 15 years ago, I had a patient who was a flight engineer for a major airline located in Atlanta, who routinely flew L1011s internationally. I was his private physician, not his AME. This guy was depressed to the hilt, having major financial and marital problems, and while not suicidal when confronted he stated fairly clearly that while he would not kill himself, it wouldn't bother him if either he or his wife died in a car crash. Scary? I would say so. My documented medical advise was that he needed to be under the care of a psychiatrist immediately,and that he needed to take himself off flight duty. He replied that financial conditions would never allow that, and seeing a "shrink" would end his flying career, which he was not about to do.

I am under legal obligation to not violate this confidentiality. (If I had been his AME, it would have been easy to do: The AME is acting on behalf of the Federal Government, NOT on behalf of the patient.) To have done so could have resulted in my losing my practice, and my kids not going to college if I were sued by this fool. I did take up the "hypothetical" situation with the regional flight surgeon here in Atlanta, and his advise was to drop an anonymous hint to the FAA. I was facing several dilemmas with this one. In this particular instance, there would be no "anonymous" hint dropping, because the moment the guy got his letter from the FAA suggesting psychological testing, he would know where it came from. The other dilemma for me was, living in Atlanta, and frequently being on an L1011, what would I do if I found out that this guy was sitting in the 3rd seat? And I had my family on board. My resolution was that the moment I saw him, I would demand to be let off the plane. There was no way on god's green earth I was going to sit behind him or allow my family to sit behind him. So if I wouldn't fly with the guy, why should I allow anyone else to sit behind him?

Ultimately, he went elsewhere.I never informed the FAA. And shortly thereafter, the suicidal Egyptian drove a fully loaded 767 into the Atlantic. (Not the same guys,obviously)

There are rules you abide, and not to do so is a federal crime. It doesn't matter if you approve of them or not. It doesn't matter if they are arbitrary, stupid, or not to your liking. If you cannot or will not follow them, you don't fly. Just as if I as an AME decide to make my own rules, by bending theirs just a little bit, I get fired from my position. Life is just tough sometimes..
"Trust, but verify!" An old Russian proverb, quoted often by a modern American hero
 
Analog
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RE: Psychotropic Drugs And Piloting

Fri Jun 01, 2007 7:52 am

Quoting GeorgiaAME (Reply 39):
Let me give you a small story, true story.

Your story confirms what I've been saying; in this case the rules were contrary to safety. I have to give you a  thumbsup  for making the tough choice to not report the guy; I can imagine it must been a really difficult situation. Thankfully nothing happened.

I wonder if this kind of thing might present a theoretical legal liability for an airline. They will essentially fire someone for trying to correct a condition that could hurt safety. Staying depressed w/o diagnosis: fully pay. Getting diagnosed & seeking treatment in order to improve safety: you're fired (well, practically fired, right?). If the worst were to happen and a lawyer found out that the pilot had not sought medical care because he/she rightfully feared for his/her job... You can see where this is going.

Quoting GeorgiaAME (Reply 39):
It doesn't matter if you approve of them or not. It doesn't matter if they are arbitrary, stupid, or not to your liking.

It does matter; we're here to argue about the rules.  Smile
 
cdsstlcop
Posts: 2
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RE: Psychotropic Drugs And Piloting

Fri Jun 01, 2007 7:56 am

Hey guys, just thought I'd share my personal experience, I am a pharmacist in St Louis, and we have numerous pilots who use my pharmacy. Just like with other areas of the FAA medical requirements, this one is being circumvented. Several of these pilots are on antidepressants, they just pay the cash price for them, not running them through their insurance, so there is no record with their employer that can be audited, showing what psych medicines they are on. Just thought I'd share. BTW this is my first post, though have been following this forum for quite a while, glad to finally have gotten involved. Thanks

[Edited 2007-06-01 01:04:38]
 
Analog
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RE: Psychotropic Drugs And Piloting

Fri Jun 01, 2007 8:08 am

Quoting Cdsstlcop (Reply 41):
Several of these pilots are on antidepressants, they just pay the cash price for them, not running them through their insurance, so there is no record with their employer that can be audited, showing what psych medicines they are on

Why am I not surprised?

Thanks, and welcome!
 
N353SK
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RE: Psychotropic Drugs And Piloting

Fri Jun 01, 2007 8:21 am

Say a pilot is diagnosed with depression and treated for it. Does he have a reasonable chance of passing a physical sometime down the road? If so, how much of a "recovery time" is usually required?
 
Analog
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RE: Psychotropic Drugs And Piloting

Fri Jun 01, 2007 8:29 am

Quoting N353SK (Reply 43):
Say a pilot is diagnosed with depression and treated for it. Does he have a reasonable chance of passing a physical sometime down the road? If so, how much of a "recovery time" is usually required?

I'd love to know the answer. Plus, what are the airlines' policies (typically) regarding disability pay, insurance, rehiring, & seniority in this type of situation. How expensive would such a diagnosis be, say if it lasted one year until the pilot was "cured" (to be totally arbitrary)?
 
ual777
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RE: Psychotropic Drugs And Piloting

Fri Jun 01, 2007 8:38 am

Quoting N186BD (Reply 20):

Not to get too personal, but atm I'm on 40mg of Prozac once daily and 1.5 mg of Ativan/Temesta (generic: Lorazepam) three times daily.

To tell you the truth, I link all of this anxiety to being at college/university. I feel that if I were in an environment such as pilot training, I would not need these medicines, as I would be concentrating on such a specific goal.
What I%u2019m trying to say%u2026 would it be possible for me to be eligible for flight training? I have been talking to my doctors about the meds, and they do not think I will need them by the time I finish uni/ share the same opinions as me (that I will not need the medication after university).

I would love any feedback that you may have; all these years have made me pretty thick skinned.

wmb

I will give my opinion. I am 6 classes from finished my BS degree and I will be taking my instrument check-ride next month.

I will say this: Pilot training is 10 times harder and stressful than any university class I took. When you are doing VOR holds in night IMC (Instrument Meteorlogical Conditions) and you are getting mercilessly thrown around, start to feel (and mentally fight) spacial disorientation, and can't see a dam* thing for the first time, you will feel scared and stressed to the MAX.

Flight training is the most rigerous endeavor I have ever undertaken...including recruit training for the Marines on Parris Island.

Quoting GeorgiaAME (Reply 32):
Nothing could be further from the truth. It is neither arbitrary, unfair, nor does it encourage denial. A history of depression does not exclude you from the cockpit. BUT you do have to meet minimal FAA standards, just as you have to meet blood pressure or visual standards. Is it arbitrary and unfair that a color blind individual is forbidden to fly at night? Or is is prudent? Meet their criteria, provide them with the documentation that they require to convince them that you are not a danger to yourself or others on the ground, and you get your medical certificate. Play games, you stay on the ground. If you present even a remote danger to someone on the ground, you have no business being in the air, no matter how much you want to be.

Spot on. I don't want to be with anyone in an emergency/dicey situation who takes these types of drugs. It is a safety issue................now, where can I get a copy of your eye chart?  Wink
It is always darkest before the sun comes up.
 
flybyguy
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RE: Psychotropic Drugs And Piloting

Fri Jun 01, 2007 8:47 am

Quoting Falstaff (Reply 4):
Example. Lets say some guy is suffering from depression. A doctor gives said person an antidepressant. The person feels fantastic and his life is all roses. If he tried to get a medical he would be denied. However if that same person never got treatment for his depression and able to pass his physical he could get his medical no problem. I would think the FAA would rather have a person in the cockpit who is being medicated and is ok than the mystery of wondering if that person is going without treatment just so they can continue to fly.

Apparently, even though there are depressed pilots not seeking treatment, planes are not making suicidal spirals to the ground on a regular basis, so the system works as far as the government is concerned.
"Are you a pretender... or a thoroughbred?!" - Professor Matt Miller
 
aa757first
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RE: Psychotropic Drugs And Piloting

Fri Jun 01, 2007 9:00 am

Quoting MD80fanatic (Reply 21):

After reading this thread......I have decided to NEVER fly again. Seriously...thanks for the warning.

Seems rational.

Quoting MD80fanatic (Reply 21):

Words of advise (to all), quit going to doctors and quit doing all these drugs. Kids never need prozac....it's Dista Products (manufacturer) the doctors that get rich prescribing it who need prozac.

Could you please back that up with some scientific studies?

Quoting GeorgiaAME (Reply 39):
There are rules you abide, and not to do so is a federal crime. It doesn't matter if you approve of them or not. It doesn't matter if they are arbitrary, stupid, or not to your liking. If you cannot or will not follow them, you don't fly.

I definitely agree with you saying you have to follow them now, but when a rule is stupid or arbitrary, it should probably be changed.

Quoting UAL777 (Reply 45):
Spot on. I don't want to be with anyone in an emergency/dicey situation who takes these types of drugs. It is a safety issue...

Someone with untreated anxiety or depression is a safety issue. Someone taking a regulated medication with a doctor's prescription is not.

Roll to an ER. The guy with his hands in someone's gut, screaming orders out, having numbers and acronyms shouted back at him, watching half a dozen screens, listening to two or three different alarms and thinking about a hundred "what ifs" could very well be taking Zoloft or Prozac. Same thing goes for the paramedic, the nurse, the anesthesiologist and probably hundreds of thousands of people in high stress occupations.

Just out of curiosity, how does the FAA find out about such conditions? Do they just ask the pilot or do they do testing?
 
Analog
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RE: Psychotropic Drugs And Piloting

Fri Jun 01, 2007 9:04 am

Quoting Flybyguy (Reply 46):

Apparently, even though there are depressed pilots not seeking treatment, planes are not making suicidal spirals to the ground on a regular basis, so the system works as far as the government is concerned.

I realize you're being sarcastic, but why not then allow pilots to seek treatment?

Another oddity is the FAA's odd interpretation of meds. You take drug A (used for conditions X, Y, and Z) and you must have condition X, which is contraindicated with flying, even though you may have condition Y or Z, neither of which prevents getting a medical. Where did this come from?
 
N353SK
Posts: 824
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RE: Psychotropic Drugs And Piloting

Fri Jun 01, 2007 10:07 am

Quoting Aa757first (Reply 47):
Just out of curiosity, how does the FAA find out about such conditions? Do they just ask the pilot or do they do testing?

Any airline pilot needs to have a first class medical certificate, which must be renewed (IE flight physical) every six months.

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