AR385
Topic Author
Posts: 6763
Joined: Fri Nov 07, 2003 8:25 am

Pilots And Antidepressants

Fri Jul 07, 2006 5:10 pm

Seeing that these days antidepressants are being prescribed like bubble gum in some countries, what are the regulations concerning a pilot who takes them? Are they temporarily suspended? Can they take them and still fly a 747 across half the world?
 
kaddyuk
Posts: 3697
Joined: Thu Nov 08, 2001 1:04 am

RE: Pilots And Antidepressants

Fri Jul 07, 2006 5:13 pm

Quoting AR385 (Thread starter):
what are the regulations concerning a pilot who takes them? Are they temporarily suspended? Can they take them and still fly a 747 across half the world?

They would probably be removed from duty and grounded. I doubt they'd loose their licence. But may be expected to undergo intense Psychometric Analysis and lots of medical check ups before returning to work. (Included would be any re-training associated with a return to duty after prolonged periods away from type...)
Whoever said "laughter is the best medicine" never had Gonorrhea
 
jcs17
Posts: 7376
Joined: Mon Jun 18, 2001 11:13 am

RE: Pilots And Antidepressants

Fri Jul 07, 2006 5:25 pm

Well, basically, in Los Estados Unidos, anti-depressants are a no-go. You basically are prescribed them and take them, you cannot fly. It's completely ridiculous.

Up to 30% of people in the Western world are depressed to the point of medication at some point in their lives. Anti-depressants are important drugs for many people, and for the majority, they make a major difference in their lives.

What I would ask is; would you rather have someone who is depressed and being successfully treated behind the stick, or someone who hides it and doesn't take medication for it behind the stick. You'd be surprised in random polls about the number of pilots hiding their anti-depressant medication to the FAA.
America's chickens are coming home to rooooost!
 
rolfen
Posts: 1539
Joined: Tue Jan 17, 2006 6:03 am

RE: Pilots And Antidepressants

Fri Jul 07, 2006 6:57 pm

How can you be depressed when you work the best job in the world?  Smile

Those pilots who experience depression must not be there in the 1st place, they should take up an office job in some insurance company and leave their place to people who really enjoy flying.
rolf
 
PhilSquares
Posts: 3371
Joined: Sun Mar 28, 2004 6:06 pm

RE: Pilots And Antidepressants

Fri Jul 07, 2006 7:10 pm

Quoting JCS17 (Reply 3):
What I would ask is; would you rather have someone who is depressed and being successfully treated behind the stick, or someone who hides it and doesn't take medication for it behind the stick. You'd be surprised in random polls about the number of pilots hiding their anti-depressant medication to the FAA

And could you share some of the "random polls"? Seriously, I really doubt what you're saying.

The problem with anti-depression medication is the side effects, not the fact someone is taking the meds in the first place. There are some very serious side effects that come with the medications. In fact, that's really the issue of sick leave is a very near and dear subject to pilots. When pilot's have a medical issue ant they're put on medication, we don't have the option of going to work on the medications just as if we worked in a non-flying job. So, if a pilot has a 14 day trip and he is on some dedication for 3 days, guess what? He has to get off the entire trip. Not a good deal.

Quoting Rolfen (Reply 4):
How can you be depressed when you work the best job in the world?

Those pilots who experience depression must not be there in the 1st place, they should take up an office job in some insurance company and leave their place to people who really enjoy flying.

Please see my above reply. You need to get real!!!
Fly fast, live slow
 
milan320
Posts: 818
Joined: Mon Jan 03, 2005 2:25 pm

RE: Pilots And Antidepressants

Fri Jul 07, 2006 7:21 pm

Quoting Rolfen (Reply 4):
Those pilots who experience depression must not be there in the 1st place, they should take up an office job in some insurance company and leave their place to people who really enjoy flying.

You could have the best job in the world and be depressed as real depression is a medical condition in many cases. Depends on family history etc. a simple great job may cure it in the short run, but not necessarily in the long run. Some people are more susceptible to it than others. The problem is when people think it's not "man" to be depressed, as in certain "macho" cultures. Too bad that such attitudes prevail as there are those who may need help with medication and hide it due to feelings of embarrassment, etc.
-Milan320
I accept bribes ... :-)
 
jap
Posts: 2196
Joined: Thu Oct 13, 2005 7:25 am

RE: Pilots And Antidepressants

Fri Jul 07, 2006 7:55 pm

I don't know... some anti-depressants are not so strong that you can't operate heavy machinery. I'd guess it depends on the type- some types have absolutely no sideeffects, while others make you tired, dizzy, coldsweating and just generally not able to make you function as a pilot for any kind of method of transportation.

With the somewhat mild typed that don't really do anything, why not? It's like taking penicillin, fishoil/garlic tablets, etc.
Scandinavian chick with a scandinavian horse- oh yeah! :D
 
jap
Posts: 2196
Joined: Thu Oct 13, 2005 7:25 am

RE: Pilots And Antidepressants

Fri Jul 07, 2006 8:00 pm

Quoting Rolfen (Reply 4):
How can you be depressed when you work the best job in the world? Smile

Those pilots who experience depression must not be there in the 1st place, they should take up an office job in some insurance company and leave their place to people who really enjoy flying.

You know nothing, do you?! WHY do you talk about matters like this when you know absolutely nothing? It's like the anorexia thread all over again!

Trust me, I've had a depression. It comes for various reasons, not only the job, but family matters, bullying, etc. My depression almost drove me to killing myself- yet I have the best family in the world, I finally got accepted into my dream-education, I was moving out- but I still got depressed- not because of all of this, but because some arseholes bullyed me ever since I started in kindergarten, up until I left school in 9th grade.

Depression can have lots of reasons! If one of the pilots' wife/kid/grandmother/mother died and he gets depressed, can you honestly tell me he doesn't deserve his job? Oh wait, "he can't get depressed, he has the best job in the world!".

YOU need to get real.
Scandinavian chick with a scandinavian horse- oh yeah! :D
 
PhilSquares
Posts: 3371
Joined: Sun Mar 28, 2004 6:06 pm

RE: Pilots And Antidepressants

Fri Jul 07, 2006 8:23 pm

Quoting Jap (Reply 7):
I don't know... some anti-depressants are not so strong that you can't operate heavy machinery. I'd guess it depends on the type- some types have absolutely no sideeffects, while others make you tired, dizzy, coldsweating and just generally not able to make you function as a pilot for any kind of method of transportation.

With the somewhat mild typed that don't really do anything, why not? It's like taking penicillin, fishoil/garlic tablets, etc.

Remember, you're stating that from the position of having a "normal" schedule, not operating in a 6000'-8000' workplace. Medications that have no or little side effects in a "normal envirornment" but change that to reflect the types of things pilots have to deal with. I have no problem with the FAA/CAA/JAA erring on the side of safety. How many "wonder" drugs such as Vioxx, have been released only to find out after the fact there are long term issues?
Fly fast, live slow
 
rolfen
Posts: 1539
Joined: Tue Jan 17, 2006 6:03 am

RE: Pilots And Antidepressants

Fri Jul 07, 2006 10:07 pm

Quoting Jap (Reply 8):

You know nothing, do you?! WHY do you talk about matters like this when you know absolutely nothing? It's like the anorexia thread all over again!

Well I was just thinking out loud, dont take me too seriously  Smile
I am a bit depressed, but I believe that if I was a pilot i'd feel much better, just the fact of stepping in a plane, flying and then landing somewhere else uplifts my mood to no end.

Yet I understand that you can have a lots of thing in your life, and still feel depressed. I have been blessed with so many things and never even noticed, and it did not help me in feeling any better. I am sure lots of people envy me and think that I lead a great life filled with nothing but good surprises but that is so not the case.

So that's for "getting real"  Smile sorry for throwing provocative posts.

As for the question, there are 2 major considerations:
- The effect on the performance of the pilot.
- Whether the chance of suicidal acts and other irrational acts significantly increases.
rolf
 
jap
Posts: 2196
Joined: Thu Oct 13, 2005 7:25 am

RE: Pilots And Antidepressants

Fri Jul 07, 2006 10:17 pm

Well, Rolfen... having had a severe depression myself and actually getting that comment ("everything you have is so good, you can't be depressed!" and so on) a few times, I'm a bit defensive when it comes to people dissing someone with a depression. Sorry if you were kidding around.
Scandinavian chick with a scandinavian horse- oh yeah! :D
 
mhodgson
Posts: 4673
Joined: Mon Dec 30, 2002 8:47 pm

RE: Pilots And Antidepressants

Fri Jul 07, 2006 10:22 pm

I believe for the CAA, those applying for a Class 1 medical who have suffered from depression will be judged on a case-by-case basis by an AME, presumably with an interview and opinions from a GP.
No trees were harmed by this message. However, several million electrons were terribly inconvenienced
 
rolfen
Posts: 1539
Joined: Tue Jan 17, 2006 6:03 am

RE: Pilots And Antidepressants

Fri Jul 07, 2006 10:42 pm

Quoting Jap (Reply 12):
Sorry if you were kidding around.

My sense of humour is a bit er...  scratchchin  hard to get
Just say what you think I like it when you're frank  Smile
rolf
 
rolfen
Posts: 1539
Joined: Tue Jan 17, 2006 6:03 am

RE: Pilots And Antidepressants

Fri Jul 07, 2006 10:50 pm

Added you to my R.U. for telling the truth.

I was just being jealous for those with such a great job.

[Edited 2006-07-07 16:11:05]
rolf
 
jap
Posts: 2196
Joined: Thu Oct 13, 2005 7:25 am

RE: Pilots And Antidepressants

Fri Jul 07, 2006 10:55 pm

Quoting Rolfen (Reply 15):
Added you to my R.U. for telling the truth.

Thanks-- I'd add you back, but apparently, I'm over my limit  irked  And I'm NOT going for First Class membership!!  rotfl 
Scandinavian chick with a scandinavian horse- oh yeah! :D
 
lowrider
Posts: 2542
Joined: Wed Jun 30, 2004 3:09 am

RE: Pilots And Antidepressants

Fri Jul 07, 2006 11:32 pm

Quoting PhilSquares (Reply 10):
Remember, you're stating that from the position of having a "normal" schedule, not operating in a 6000'-8000' workplace. Medications that have no or little side effects in a "normal envirornment" but change that to reflect the types of things pilots have to deal with. I have no problem with the FAA/CAA/JAA erring on the side of safety. How many "wonder" drugs such as Vioxx, have been released only to find out after the fact there are long term issues?

 checkmark 

Many drugs are prohibited for this reason. For example, some drugs (don't aske me which, I don't have the list handy) increase a person's susceptibility to hypoxia. Not problem so long as you remain at an elevation you are accilmated to, but... Viagra, for example, can cause blue/green color blindness. The list goes on.
Proud OOTSK member
 
Shawn Patrick
Posts: 2465
Joined: Tue Jan 11, 2000 7:30 am

RE: Pilots And Antidepressants

Sat Jul 08, 2006 1:18 am

As of this date, the use of ANY psychometric drugs will require a pilot to "voluntarily ground" himself, according to the FAA.

If you look deeper into the FARs about this, though, it states that a pilot simply may not ACT as pilot-in-command while on the medication. Therefore, there are many instances in which a pilot can still fly while on the medication. For example:

1) In a GA environment, the medicated pilot just needs to have an appropriately rated safety pilot who will be acting as PIC for the flight. So, let's say I'm taking prozac and I still want to fly my Cessna on the weekends. I can still do so, even sitting in the left seat, as long as I bring a friend who is a private pilot. He will act as PIC, which means he's technically in charge of the safety of the flight. And, this doesn't even prohibit me from LOGGING PIC time. So basically, the only consequence of my taking the medication is that I have to have a safety pilot. I can still sit left seat and log PIC time.

2) Flight training. If a pilot is taking a psychometric, it doesn't prohibit him from receiving flight instruction, because he won't be acting as PIC.

3) Glider operations and light-sport aircaft. They don't require a medical, so the "voluntary grounding" requirements don't apply.

Of course, if you're acting as a required crewmember, then you're out of the game. So if a Captain or FO on a part 121/135 operation is taking a psychometric, then he's gotta ground himself.

Just shedding some light.
Shawn
 
AirWillie6475
Posts: 2372
Joined: Thu Jan 27, 2005 1:45 pm

RE: Pilots And Antidepressants

Sat Jul 08, 2006 2:05 am

They are strict on medication. There is a small list of what you can take and antideps are not one of them. I'm ashamed to admit that I took antideps for half a month but not for depression but for anxiety. It was the one of the worst experiences I've had, my parents even, with my request, dumped my Doctor and found another one who actually gave me advice instead of giving me pills. I'll probably never take antideps again and I can see why it's banned for flying.
 
AC773
Posts: 1700
Joined: Wed Nov 30, 2005 6:03 am

RE: Pilots And Antidepressants

Sat Jul 08, 2006 2:45 am

Quoting Jap (Reply 16):
Thanks-- I'd add you back, but apparently, I'm over my limit

Yeah, she owes me one as well. How many other people are on your "mental RU list" Janni?  laughing 
Better to be nouveau than never to have been riche at all.
 
diamond
Posts: 3000
Joined: Sun Apr 11, 2004 8:01 am

RE: Pilots And Antidepressants

Sat Jul 08, 2006 5:48 am

Quoting Shawn Patrick (Reply 17):
As of this date, the use of ANY psychometric drugs will require a pilot to "voluntarily ground" himself, according to the FAA.

I believe it is psychotropic drugs you are referring to.
Blank.
 
aa757first
Posts: 3140
Joined: Sun Aug 03, 2003 11:40 am

RE: Pilots And Antidepressants

Sat Jul 08, 2006 6:23 am

Quoting PhilSquares (Reply 5):
There are some very serious side effects that come with the medications.

Such as?

Quoting Rolfen (Reply 10):

- Whether the chance of suicidal acts and other irrational acts significantly increases.

Zoloft and Paxil (SSRIs) have that effect only in children and teens, not adults. Obviously, every commerical pilot is an adult.

Quoting AirWillie6475 (Reply 18):
I'm ashamed to admit that I took antideps for half a month but not for depression but for anxiety. It was the one of the worst experiences I've had, my parents even, with my request, dumped my Doctor and found another one who actually gave me advice instead of giving me pills.

Ashamed?  Confused

PS - Many times a patient with depression has a psychiatrist or primary care doctor manage medications and a clinical psychologist to handle the therapy aspect of the treatment.

AAndrew
 
aa757first
Posts: 3140
Joined: Sun Aug 03, 2003 11:40 am

RE: Pilots And Antidepressants

Sat Jul 08, 2006 6:45 am

Just to add: this policy is very dangerous. If a pilot is depression, he or she may not seek treatment because he's worried he'll loose his job. I would rather have a pilot on Zoloft than a pilot with untreated depression.

AAndrew
 
jap
Posts: 2196
Joined: Thu Oct 13, 2005 7:25 am

RE: Pilots And Antidepressants

Sat Jul 08, 2006 6:48 am

Quoting AC773 (Reply 19):
Yeah, she owes me one as well. How many other people are on your "mental RU list" Janni? laughing

10 people or so  sigh 
Scandinavian chick with a scandinavian horse- oh yeah! :D
 
Bobster2
Posts: 1523
Joined: Mon Jan 17, 2005 3:04 am

RE: Pilots And Antidepressants

Sat Jul 08, 2006 8:39 am

I just checked and the FAA doesn't consider caffeine and nicotine to be drugs. So you can self-medicate yourself all you want just so long as you stick to caffeine and nicotine. Wow.

I have some experience using caffeine for depression before I went to a doctor and got something better. I feel very sorry pilots who have to depend on caffeine as their only hope.
"I tell you this, no eternal reward will forgive us now for wasting the dawn." Jim Morrison
 
AR385
Topic Author
Posts: 6763
Joined: Fri Nov 07, 2003 8:25 am

RE: Pilots And Antidepressants

Sat Jul 08, 2006 9:10 am

I have been taking antidepressants daily for about seven years. Thus, I have read a lot on the topic. I have major clinical depression. About 15% of people with depression will kill themselves and are pretty successful at it. It is interesting what is being said about preferring a pilot on antidepressants rathar than one depressed and unable to take medication. In my opinion, the Silk Air flight and the Egyptair 990 were downed by pilots suffering from depression
 
Bobster2
Posts: 1523
Joined: Mon Jan 17, 2005 3:04 am

RE: Pilots And Antidepressants

Sat Jul 08, 2006 9:48 am

Quoting AR385 (Reply 24):
In my opinion, the Silk Air flight and the Egyptair 990 were downed by pilots suffering from depression

If they crashed intentionally it was homicide. Are you trying to suggest that depression causes people to kill innocents? That's the kind of thinking that makes it harder for people with depression to get help.
"I tell you this, no eternal reward will forgive us now for wasting the dawn." Jim Morrison
 
PhilSquares
Posts: 3371
Joined: Sun Mar 28, 2004 6:06 pm

RE: Pilots And Antidepressants

Sat Jul 08, 2006 9:52 am

Quoting Aa757first (Reply 20):
Such as?

How about doing some research yourself? For instance, if you're on certain types of antibiotics, you are subject to nausea. Shall I continue?

Quoting Aa757first (Reply 21):
I would rather have a pilot on Zoloft than a pilot with untreated depression.

Glad you would, but no regulatory body in the world shares your opinion.
Fly fast, live slow
 
AR385
Topic Author
Posts: 6763
Joined: Fri Nov 07, 2003 8:25 am

RE: Pilots And Antidepressants

Sat Jul 08, 2006 10:58 am

Quoting Bobster2 (Reply 25):
Are you trying to suggest that depression causes people to kill innocents?

I am not trying. I am suggesting it. Depression causes all types of behaviour. A common one is disassociation and indifference. It is perfectly possible for that scenario I am suggesting actually happened. There is evidence the pilots involved were depressed. Depression also can manifiest itself as anger. In this case anger towards their companies. They might have done what they did under a "I'll show them mentality".

Keep in my mind that it is my opinion, I am not saying it happened. I am saying depression might have been the cause. It's merely a conjecture.
 
n8076u
Posts: 419
Joined: Mon Jun 19, 2006 10:52 am

RE: Pilots And Antidepressants

Sat Jul 08, 2006 11:18 am

What this really comes down to is the fact that everyone is different. Two people with depression will not respond the same to the same medication. One may feel better, the other may feel the same or worse. Their depression may also be misdiagnosed, as some medications made for treating depression will cause problems with someone that is actually manic-depressive, for instance. Every medication also has different side effects, some common, some not so common. Since there is no way of telling how someone may react to a given medication, or what side effects may come to light at a given time, or what reaction the medication will trigger when a certain event takes place (high altitude, high stress, etc.). So just because a pilot is taking a medication that is "supposed" to help him, it may in fact be doing the opposite, and he or his doctor may not even realize it.

Chris
Don't blame me, I don't work here...
 
Max Q
Posts: 5695
Joined: Wed May 09, 2001 12:40 pm

RE: Pilots And Antidepressants

Sat Jul 08, 2006 2:23 pm

JCS17

Well said, I am firmly on the side of those who need help with depression.

I believe that, after an individual determines and or is certificated for the use of anti-depressants they should be allowed to fly.

It's just not that simple, people need help and they should be allowed to get it.
The best contribution to safety is a competent Pilot.
 
FredT
Posts: 2166
Joined: Thu Feb 07, 2002 9:51 pm

RE: Pilots And Antidepressants

Sat Jul 08, 2006 3:12 pm

Having my family distributed between health care and aviation, I have some insight into the issue. It is not my real field of expertise though, so take what is below as my amateur opinions.

The peculiar thing about medicals and antidepressants, compared to most other drugs, is that while in other cases, the ban is on the individual drugs, there is a blanket ban on antidepressants. If you suffer from other illnesses, you can take some drugs and fly while other drugs ground you. If you suffer from depression, any medication will ground you. If there was (or even is) a drug which helps with symptoms of another disease as well as symptoms of depression but which has no negative side effects for flying, taking it against the other disease will let you fly but if you take it against depression, it'll ground you.

This of course means that depression is something commercial pilots do not ever suffer from.

Now, with some 25% of the general population suffering from a diagnosable depression at some point in life, do we believe that commercial pilots are superhuman enough to stand out from those statistics, or do we believe that they simply push on and fly with untreated depressions and/or make sure to get the medication on the side, out of sight of the aviation autorities and likely with less control than if they were to receive treatment for it in the open?

It's not something that's often talked about, but it is not uncommon for commercial pilots to have one "health doctor", which is used to get the A-OK stamp for the medical, and one "sick doctor" which is used when something is ailing. And never must those two meet...

The subject is interesting on many levels, and I do believe the current status of affairs detract from flight safety.

Rgds,
/Fred
I thought I was doing good trying to avoid those airport hotels... and look at me now.
 
PhilSquares
Posts: 3371
Joined: Sun Mar 28, 2004 6:06 pm

RE: Pilots And Antidepressants

Sat Jul 08, 2006 3:51 pm

Quoting FredT (Reply 30):
It's not something that's often talked about, but it is not uncommon for commercial pilots to have one "health doctor", which is used to get the A-OK stamp for the medical, and one "sick doctor" which is used when something is ailing. And never must those two meet...

I beg to differ, it is very rare! In this day of computerized medical records, health insurance, NHS if you try to do what you're saying, you are risking more than your license. You are looking at some serious issues if you're caught.

If you go to a good AME, he/she will be able to help you with what ever issues you face. They may not be able to prescribe medication to treat depression, but counseling is available and not "verboten".

The AME is in a position to wear two hats, one for the you and the other for the FAA/CAA/JAA. They are normally in a position of advocacy for you with the regulatory agency.
Fly fast, live slow
 
WSOY
Posts: 822
Joined: Tue Jun 13, 2006 10:24 pm

RE: Pilots And Antidepressants

Sat Jul 08, 2006 9:55 pm

Does anybody know when the anti-antidepressant rule was last reviewed? If it dates from the era of the tricyclic antidepressants (1960s, I suppose), there may be some sense in it, as they have a strong sleep-inducing effect, at least initially during the treatment. With the modern molecules that have seen a very comprehensive use across the population, it just does not make sense. Having to have two sets of medical histories, one for yourself, one for the system, sounds very "1984" to me.
"Nukkuessa tulee nälkä" (Nipsu)
 
flygaz
Posts: 70
Joined: Fri Nov 19, 2004 8:43 pm

RE: Pilots And Antidepressants

Sun Jul 09, 2006 3:38 am

I agree that pilots taking anti-depressents should not be able to fly. A depressed pilot will not have his mind focused on his flying, possibly becoming distracted etc, and increasing the risks to his/hers flight.
Taking the anti-depressents just masks the problems not treats the cause. If a pilot flies taking the medication there is potentially problems with doseage - too much and increased side effects, too little and it may not 'mask' the symptoms of depression enough.
This is not saying that anti-depressents do not work, I know many people whose life has been improved by having them prescribed.
I also think that pilots should not be ashamed of admitting depression. They need to be trusted by the authorities and airlines that they will voluntarily stop flying. In return the airlines should be understanding about the condition and assist the pilot to come back to work when the depression has been sucessfully treated, maybe with factors such as reduced hours and support measures.
 
pjflysfast
Posts: 442
Joined: Wed May 31, 2006 11:05 pm

RE: Pilots And Antidepressants

Sun Jul 09, 2006 5:33 am

[quote=Lowrider,reply=15]For example, some drugs (don't aske me which, I don't have the list handy) [/quote

I know you said dont ask but I am anyway. Is Zoloft a drug that could prevent someone from being a pilot??
 
WSOY
Posts: 822
Joined: Tue Jun 13, 2006 10:24 pm

RE: Pilots And Antidepressants

Sun Jul 09, 2006 6:09 am

Imagine a 25-year old clinically depressed co-pilot working for a smallish regional company. Which is it going to be: "please hire another young lad for my place while I recover, only I can't tell you exactly how long it'll take so you will keep my seat warm won't you", or "I'm going to ask any doctor quietly for an anti-depressant presciption (or use someone else's medicine chest) and continue in my work, my condition should with luck be improving already after a month, and nobody will ever know"?
"Nukkuessa tulee nälkä" (Nipsu)
 
bri2k1
Posts: 952
Joined: Sun Dec 19, 2004 4:13 am

RE: Pilots And Antidepressants

Sun Jul 09, 2006 6:29 am

Quoting PJFlysFast (Reply 34):
Is Zoloft a drug that could prevent someone from being a pilot??

Yes. The AOPA members web site maintains a searchable database of medications pursuant to certification for FAR parts 61 and 91, that is, private pilot operations. That web site lists Zoloft (sertraline HCl) as "NOT ALLOWED" by the FAA. It gives the following disclaimer:

Quote:
This database is compiled by the AOPA Medical Certification Department and is based upon confirmation with the FAA Aerospace Medical Certification Division in Oklahoma City. Although these medications are generally allowed by the FAA for flight duties, there are variables with each individual's situation that could render a particular medication inappropriate for flying because of case history or adverse side effects. Some medications are being used "off label". This means that a drug is prescribed for symptoms that do not fall within the FDA's approval guidelines for that drug. This is just one example of why the FAA might not approve a drug that is on the list.

FAR 61.53 prohibits a person from acting as pilot in command or as a required pilot flight crew member while that person (1) "knows or has reason to know of any medical condition that would make the person unable to meet the requirements for the medical certificate necessary for the pilot operation"; or, (2) "Is taking medication or receiving other treatment for a medical condition that results in the person being unable to meet the requirements for the medical certificate necessary for the pilot operation."

FAR 91.17 states (a) No person may act or attempt to act as a pilot crewmember of a civil aircraft�

(3) While using any drug that affects the person's faculties in any way contrary to safety�

Although we maintain the medications list as accurately as possible, there may be drugs that do not appear in the database. If you have any questions about a particular medication that does not appear, contact the Medical Certification specialists on the AOPA Pilot Information Center, 800/872-2672.

Anyone who is interested in becoming a pilot and has any particular medical or other concern should pay the $29 to become an AOPA member and take advantage of the wealth of resources they have available.

Quoting WSOY (Reply 35):
"I'm going to ask any doctor quietly for an anti-depressant presciption (or use someone else's medicine chest) and continue in my work, my condition should with luck be improving already after a month, and nobody will ever know"

That's why it's a good thing there's a drug screening as part of the 1st class medical which expires every six months.

Some of the opinions shared on this page have been very dangerous with respect to aviation. Since the #1 most important thing in aviation is safety, I truly hope these individuals are not actually involved in any operations that could affect the safety of flight. The FARs require such individuals to ground themselves if they have any known conditions which could render their medical certificates invalid; untreated major depressive disorder and/or prescription antidepressant medications do fall into that category, whether it's convenient for an individual to believe so or not.
Position and hold
 
AR385
Topic Author
Posts: 6763
Joined: Fri Nov 07, 2003 8:25 am

RE: Pilots And Antidepressants

Sun Jul 09, 2006 7:25 am

I'm not a doctor, so don't attack me. Tryciclic antidepressants were actually dangerous because they had the potential of causing liver failure, aside from sleepiness. Their success rate was also not very high, among 40 to 50%

Second generation antidepressants (Zoloft, Paxil, Prozac) are not so hard on the liver, although the occassional liver function blood test is needed. The physical side effects depend on the person. But they are not major and if given the correct dose and not abused by the taker, are usually nausea, dizziness, constipation, dry mouth, impotence, a bad, bad reaction if drank with alcohol, occassional tremblors on the arms and legs, confusion, and others not as important. These side effects, only last from the time the person started with the medication until 4 to 5 weeks later. Then, they disappear. So, it might be a good idea for the pilot to ask for a leave of absence until his side effects have dissappeared.

Depending on the person, the antidepressant will usually take between 3 to 6 weeks in achieving its full effects.

Then along came third generation antidepressants (wellbutrin, celexa) Wellbutrin is different in the sense that its impact is not on Serotonin but on Dopamine. Side effects include more energy, more concentration and more assertiveness.

I only know of one fourth generation of Antidepressants ( an advanced version on Celexa that is less hard on the liver) and has even less side effects.

As someone said, antidepressants alone are not the answer, as therapy alone is not the answer. You need a combination of both. As opposed to what a lot of people believe, taking antidepressants sans therapy will mask your depression to a point, but it will still be there. On the other hands, if you are deemed a candidate for antidepressants, no therapy will help if you do not use the chemicals available to you.

Basically I don't agree for antidepressants to ban pilots from flying. It should be a pilot's responsibility to ask for a leave of absence while his body is getting used to the antidepressant, but afterwards, pilots should be allowed to fly.
 
NZ8800
Posts: 408
Joined: Tue May 16, 2006 1:42 pm

RE: Pilots And Antidepressants

Sun Jul 09, 2006 7:27 am

What if the depression was treated with a mood stablising medication like Tegretol/Carbamazepine, instead of an antidepressant? They also treat epilepsy...

And - as an aside - does having a fit mean you can never be a pilot, or do you get grounded for six - 12 months like you do if you have a car licence? What if you never had a fit again?

Just wondering...
MDZWTA ~ Mobile Disaster Zone When Travelling Abroad
 
pjflysfast
Posts: 442
Joined: Wed May 31, 2006 11:05 pm

RE: Pilots And Antidepressants

Sun Jul 09, 2006 7:29 am

Thanks for that information. So if I read correctly Zoloft can prevent people from becoming a pilot. I personally dont agree with the FAA there because it doesn't mean the person is mentally handy caped in any means. Zoloft doesn't make your decision thought process any slower or does it effect your body and health in any way.
 
WSOY
Posts: 822
Joined: Tue Jun 13, 2006 10:24 pm

RE: Pilots And Antidepressants

Sun Jul 09, 2006 7:40 am

Quoting AR385 (Reply 37):
Basically I don't agree for antidepressants to ban pilots from flying. It should be a pilot's responsibility to ask for a leave of absence while his body is getting used to the antidepressant, but afterwards, pilots should be allowed to fly.

Yes to that!

And what about caffeine? It is used as a matter of routine by many aviators to hide the ill effects of fatigue. Fatigue, then, has been established as a primary or contributory reason in a consirable number of accidents. Decaffeinate and establish proper crew sleep regimes? Too costly??
"Nukkuessa tulee nälkä" (Nipsu)
 
SlamClick
Posts: 9576
Joined: Sun Nov 23, 2003 7:09 am

RE: Pilots And Antidepressants

Sun Jul 09, 2006 8:18 am

I am probably going to anger some people with this post. That is not its purpose at all, but my opinions are somewhat unbending on this issue and will likely appear to some, to be cold-hearted.

Most of us have quite likely experienced depression in some form. I understand that it does not depend on, or even necessarily feed on, things actually being bad. People in what appear to be the best of circumstances may even suffer higher rates of depression than 'normal' people. Witness Kobain's suicide. Poor guy! Making too much money, too popular, couldn't stand it!

I believe (I HOPE!) that the FAA considers not only the medication but the reason you must take it. Case in point, for a while I was medically grounded and for a very short time I was taking Antivert for dizziness. Grounding medication but the underlying reason for taking it is also grounding.

If you take antidepressants I can conclude that you are depressed to the point of requiring medication to control it.
I don't take them but you cannot conclude that I am merely unmedicated -depressed. Maybe I'm not depressed at all.

If you become aware of my self-medication, e.g. I get knee-walking drunk on layovers, you might start a discreet inquiry, but otherwise you'll just have to assume that I'm okay.

It is my experience that there are two kinds of people.

Self-medicating people: Not only 'self' but they go to doctors for prescriptions. Their solutions include alcohol, marijuana, other recreational drugs, self-produced drugs like adrenalin or endorphins and others I'm probably not even aware of. Alcoholics almost uniformly fall into this category or you'd never see coffee and cigarettes at an AA meeting. (Ever been to one?)

Non-self-medicating people: I fall into this category. Don't drink much mostly because I hate being intoxicated. Never smoked giggleweed beyond the obligatory youthful attempt. Never did other drugs, HATE going to the doctor - stop most medication early. I like pain more than I like Vicodin or anything stronger than Tylenol.


I believe that these two types of people are almost different species.

I don't believe they understand each other.
I don't believe they trust each other.

I believe that self-medicators think everyone is a self-medicator or a liar.

Now the really important part.

Being a pilot is a privilege not a right.
The privilege is granted at the discretion of a governing body and all the usual legal protections you might be used to probably do not apply. For example if they accuse you of something YOU ARE GUILTY. You are guilty until you've begun paying the penalty, contest the action and prove them wrong in their own court. There is no presumption of innocence.

They decide whether or not you are fit to hold a license on medical grounds as well as knowledge and ability.

Speaking for the US FAA, they have the Aeromedical Branch in Oklahoma City and these guys really are pretty good at what they do. I don't always agree with them but, except for the Bob Hoover grounding they are pretty fair and even handed. They also have access to an enormous body of aeromedical knowledge and expertise. They have specialists in any discipline you can imagine. If they have decided that antidepressants are a no bueno then that is just going to be the way it is.

They eventually change their minds about certain conditions, depending on new procedures, new medications. When I was diagnosed with Ménierè's Syndrome (dizziness) it was grounding-for-life. Apparently they revisited it at some time and concluded that it does burn out after some time and episodes. It takes hearing with it, but if you can pass their hearing test and if you can be expect not to be incapacitated by dizziness while on duty you may get your medical back. I've flown with a captain with one glass eye. I've flown with guys coming back from open heart surgery. The FAA medical guys are reasonable and responsible, it seems.

They presently deem that if you require antidepressant drugs to control depression you are not medically qualified to operate an aircraft.
Period.
Paragraph.

My ENT and I did not presume to debate their wisdom.

Quoting WSOY (Reply 35):
Imagine a 25-year old clinically depressed co-pilot working for a smallish regional company. Which is it going to be: "please hire another young lad for my place while I recover, only I can't tell you exactly how long it'll take so you will keep my seat warm won't you", or "I'm going to ask any doctor quietly for an anti-depressant presciption (or use someone else's medicine chest) and continue in my work, my condition should with luck be improving already after a month, and nobody will ever know"?

This is very much at the heart of my 'self-medicating people' hypothesis. If a pilot were to deliberately take medication which invalidates his medical certificate that is an act bordering on criminal. This is a character issue.

I would NEVER do such a thing, no matter how badly I wanted to fly. It is grossly, wildly irresponsible and I sincerely believe that such a person should go to prison.

However, self-medicators (other than common alcoholics) are almost exclusively liberal politically. And liberals often do not understand what we mean when we say 'character.' They think we are talking about Christianity. I'm not. I'm talking simple right and wrong and almost NO shades of gray whatever.

And there is the problem.

There are a few people whose attitudes about drugs in general are pretty fuzzy, who will think it is their RIGHT to fly an airplane. Possibly under the influence of a drug but certainly under the influence of a condition requiring a drug, they will decide to fly anyway.

It is for this reason that I will not fly in private airplanes anymore unless I am the pilot. I will not fly on foreign flagged airliners.

I really am sorry that your condition requires a chemical to control, but NO, you do not have the right to fly.

I don't mean to sound preachy.

I DO mean to sound like a cop. I'll turn you in for certain if I become aware of it. The safety of passengers is more important than your happiness. It is just that simple.
Happiness is not seeing another trite Ste. Maarten photo all week long.
 
User avatar
Starlionblue
Posts: 17211
Joined: Fri Feb 27, 2004 9:54 pm

RE: Pilots And Antidepressants

Sun Jul 09, 2006 8:47 am

Quoting SlamClick (Reply 41):
However, self-medicators (other than common alcoholics) are almost exclusively liberal politically. And liberals often do not understand what we mean when we say 'character.' They think we are talking about Christianity. I'm not. I'm talking simple right and wrong and almost NO shades of gray whatever.

Ironic isn't it? And therein lies the difference between what I think is a conservative or liberal and what the press labels a conservative or liberal.

Quoting SlamClick (Reply 41):
I will not fly on foreign flagged airliners.

What, not even Swedish? That's weird man. I mean, I understand not flying Central African Bush Air Cargo, but SAS? I assure you the regulatory environment AND national character (for lack of a better word) is in line with your attitudes.

Quoting SlamClick (Reply 41):

I DO mean to sound like a cop. I'll turn you in for certain if I become aware of it. The safety of passengers is more important than your happiness. It is just that simple.

Agreed. I always give up conversations with people who think they have "a right" to xyz. Sure you have a right to get blind drunk/high/low/wasted, but not on the same road where I drive a car with my daughter in the back.

And that's the difference between libertarians with a brain ("I do what I want but I still used common sense") and libertarians without a brain ("you're not the boss of me!")
"There are no stupid questions, but there are a lot of inquisitive idiots." - John Ringo
 
turnit56N
Posts: 230
Joined: Wed Nov 02, 2005 12:13 am

RE: Pilots And Antidepressants

Sun Jul 09, 2006 8:58 am

I have to agree with SlamClick, especially the point about how flying aircraft is not a right.

Remember that commercial aviation is one of the very few industries in the politically correct US that is allowed to discriminate based on disability when hiring. A person suffering from chronic depression may not be able to help their condition any more than a person suffering from bipolar disorder (also an instantly-grounding condition) or a person who is paralyzed from the waist down, but that's beside the point. When you're responsible for the lives of a couple hundred people while zooming through the atmosphere at 39,000', what's fair takes a back seat to what's safe. Every pilot knows a colleague who either had to quit the industry or nearly had to quit the industry because of a medical condition. My aunt was forced to retire early because of vertigo, and a close instructor friend many years ago had to stop flying at the beginning of his career because of the medication he had to take for a chronic condition. That particular list could go on for a while.

The fact is that the FAA and many other regulatory agencies are very strict on what medications and medical conditions are allowed. They may seem overly harsh, but again - what's fair doesn't really matter in this industry.
Aviation is not so much a profession as it is a disease.
 
SlamClick
Posts: 9576
Joined: Sun Nov 23, 2003 7:09 am

RE: Pilots And Antidepressants

Sun Jul 09, 2006 9:27 am

Quoting Turnit56N (Reply 43):
is allowed to discriminate based on disability when hiring

It has long been my opinion that the FAA actually created a disability against which they then discriminate. I'm talking about Red-Green colorblindness. I have two friends who suffer from this. (suffer is too strong a word, neither is even aware of it in everyday life) One failed a demonstration for a waiver, involving the red-green Aldis lamp at at control tower and went on to find some other profession. The other found a way to cheat the standard test for color vision and flew out his whole career without it being a problem.

I say that the FAA created this problem by permitting the use of red and green instrument markings, lightgun signals and so on, when red-green is, by far the most common form of colorblindness. If the airplane and its government oversight were just being invented today, in the present climate toward disabilites airplanes would not have a redline, they'd have a black and white radially striped line or something like that.

I feel bad for a person who really wants to fly but has some otherwise minor physical inconvenience that prevents it. On the other hand, when I buy a ticket and expect to be flown into Seattle in the fog I don't really care enough about your disappointment. I want the pilot to be supernaturally healthy.

All through my career that is what I gave to the flying public, to the best of my ability. I voluntarily grounded myself a number of times, finally for several years! I lost the peak earnings of my profession because the flying public deserves a pilot who was in better physical shape than I was at the time. Whether or not passengers 'deserve better' was not the issue. It was out of respect for my profession and peers.

Life is just not fair. Some people wanted to be pilots. I wanted to be taller. I wanted to be better looking. I wanted to play pro baseball but I've got a 28mph fastball. I wanted to drive F1 but I have no exceptional talent. Make do with what you've got. Find something you don't suck at and do that.
Happiness is not seeing another trite Ste. Maarten photo all week long.
 
SlamClick
Posts: 9576
Joined: Sun Nov 23, 2003 7:09 am

RE: Pilots And Antidepressants

Sun Jul 09, 2006 9:31 am

Quoting Starlionblue (Reply 42):
What, not even Swedish? That's weird man.

Well, as I said in another thread, I will fly on a US-flag carrier and a very short list of others. I will not name carriers on that list because I don't really want to insult anyone (that is what Non/Av is for) and I don't care to debate my personal decision.

So if you are offended by the idea that I won't fly on your favorite airline, I probably meant a different one.  Smile
Happiness is not seeing another trite Ste. Maarten photo all week long.
 
User avatar
Starlionblue
Posts: 17211
Joined: Fri Feb 27, 2004 9:54 pm

RE: Pilots And Antidepressants

Sun Jul 09, 2006 10:07 am

Quoting SlamClick (Reply 45):
Quoting Starlionblue (Reply 42):
What, not even Swedish? That's weird man.

Well, as I said in another thread, I will fly on a US-flag carrier and a very short list of others. I will not name carriers on that list because I don't really want to insult anyone (that is what Non/Av is for) and I don't care to debate my personal decision.

So if you are offended by the idea that I won't fly on your favorite airline, I probably meant a different one.

Truly diplomatic, Captain Click  Wink
"There are no stupid questions, but there are a lot of inquisitive idiots." - John Ringo
 
WSOY
Posts: 822
Joined: Tue Jun 13, 2006 10:24 pm

RE: Pilots And Antidepressants

Sun Jul 09, 2006 8:08 pm

Quoting SlamClick (Reply 41):
They presently deem that if you require antidepressant drugs to control depression you are not medically qualified to operate an aircraft.
Period.
Paragraph.

SlamClick, I'm glad to see you left the "presently" in. I think they have got stuck really bad in an earlier era. The policy should be turned right on its head. It should be made mandatory to medicate a pilot's depression as early as possible, and to start a symptom awareness campaign!

Depressed people of the standard variety are not "Beautiful Mind" people. They have no visual or other hallusinations, and their cognitive and intellectual facilities work within limits of normality. What they experience are feelings of not belonging, worthlessness, rejection, guilt etc, and a loss of the joy of life in general. More often than not, they are very conscientious and dedicated workers. What is most important, they are always aware of their ill condition, and very painfully so. Feelings of grandeur, paranoia, etc no not occur. As the disease progresses, sleep and concentration problems usually step in. In an untreated case of depression, finally, suicide rate is unfortunately very high. There's never a "zoom from the sky", on the contrary, before a diagnosis is finally made there's almost always a period of years or decades of denial: "I/you just need to pull your/myself together".


The only cures for depression were for long alcohol and the rope. We need to get over this, finally, even in the conservative aviation circles. Medication is more than a "coverup of symptoms" of "the real reason". Nobody really knows what may cause the illness, but we know for sure that forcing a better balance of some chemicals in the brain often causes a permanent improvement in a relatively short period of time. Some will have a relapse, some will require medication all their lives. The great majority will be helped, a lot.

The most dangerous path of all is to let the current situation continue. Is it better to have pilots try and self-cure their depression "legally" with alcohol? Does it improve aviation safety to let people suffer in their personal and working lives while the cure is at hand?

[Edited 2006-07-09 13:20:04]
"Nukkuessa tulee nälkä" (Nipsu)
 
SlamClick
Posts: 9576
Joined: Sun Nov 23, 2003 7:09 am

RE: Pilots And Antidepressants

Sun Jul 09, 2006 11:17 pm

Quoting WSOY (Reply 47):
Is it better to have pilots try and self-cure their depression "legally" with alcohol?

You prove my point perfectly.

Quoting SlamClick (Reply 41):
I believe that self-medicators think everyone is a self-medicator or a liar

You think most pilots are depressed and in denial about it. You seem to think that there are huge numbers of us who are just ticking bombs.

That is yourselves you are talking about, not us. You are incapable of understanding us. You are a water skiier wondering how I waterski in the desert and not believing the obvious truth - I don't.

Accept it and move on. If you have a condition that is grounding, and you have it bad enough to be unable to get through normal life without drugs which, themselves are grounding, you should not be a pilot.
Happiness is not seeing another trite Ste. Maarten photo all week long.
 
FredT
Posts: 2166
Joined: Thu Feb 07, 2002 9:51 pm

RE: Pilots And Antidepressants

Mon Jul 10, 2006 7:29 am

Quoting SlamClick (Reply 48):
You think most pilots are depressed and in denial about it. You seem to think that there are huge numbers of us who are just ticking bombs.

I can't speak for WSOY, but I think this is a good point to reiterate the statistics I referred to above: around 25% (one figure for men, one for women, can't recall which is which) of the population is subject to diagnosable depression sometime during their lifetime.

That applies to pilots and non-pilots alike. It's mainly genetical but can be triggered by environmental factors, just like cancer. Pilot, non-pilot - no difference. Stress can be a contributing factor. Jet lag, hard and important career decisions, spending time away from the family, working odd hours... those are other possible contributing factors. I don't think I need to spell it out clearer than that.

While the right thing to do for a pilot entering a depression is to ground himself, seek medical advice and possibly medicate, I don't think that there is any debate that an individual pilot affected will see many reasons not to do the right thing.

He will be faced with a tough decision. Do the right thing, and end up without an income, perhaps a ruined career, perhaps never again having a shot at that much coveted flying job. This is especially so for young pilots.

Or he can find another way around it. Ignore the symptoms and tough it out or find means to deal with the illness that will not mean grounding.

The latter will mean a pilot flying with a depression which is not managed and treated within the normal health care system.

That is a problem and a genuine concern, and one which should be adressed.

As someone pointed out above, safety must be our first and foremost concern. This means being proactive. We must actively seek out problems, and then do something about them. Pretending that it does not happen is sticking our head in the sand.

One of the basic principles of human factors is to look at the situation from the inside. If you are trying to figure out why a pilot flew through that fatal thunderstorm rather than diverting, you have to look at it from the position the pilot was in at the time when he made the decision. This applies to the case at hand as well. Why do pilots elect to not ground themselves, in spite of suffering from depressions?

We (as in 'the aviation industry') can either do something about this problem, or do nothing. What possible solutions are there? Are the consequences of the possible solutions more severe than the consequences of the current situation (EgyptAir 990 is possibly one such consequence)? If so, we should do nothing. If not, we should act. Now, and not after something happens.
I thought I was doing good trying to avoid those airport hotels... and look at me now.

Who is online

Users browsing this forum: SAAFNAV, vikkyvik, zmiko and 9 guests

Popular Searches On Airliners.net

Top Photos of Last:   24 Hours  •  48 Hours  •  7 Days  •  30 Days  •  180 Days  •  365 Days  •  All Time

Military Aircraft Every type from fighters to helicopters from air forces around the globe

Classic Airliners Props and jets from the good old days

Flight Decks Views from inside the cockpit

Aircraft Cabins Passenger cabin shots showing seat arrangements as well as cargo aircraft interior

Cargo Aircraft Pictures of great freighter aircraft

Government Aircraft Aircraft flying government officials

Helicopters Our large helicopter section. Both military and civil versions

Blimps / Airships Everything from the Goodyear blimp to the Zeppelin

Night Photos Beautiful shots taken while the sun is below the horizon

Accidents Accident, incident and crash related photos

Air to Air Photos taken by airborne photographers of airborne aircraft

Special Paint Schemes Aircraft painted in beautiful and original liveries

Airport Overviews Airport overviews from the air or ground

Tails and Winglets Tail and Winglet closeups with beautiful airline logos