Propranolol/inderal

[tommy4931]

I have a friend who takes a 20mg pill of propranolol/Inderal before stressful situations as they act without having a build up period. I was wondering if you could take these before an AME visit as I suffer from white coat symptoms. Also, would you be able to detect these on a EKG or urine test? I know they are intended for blood pressure, but they've found that they help with anxiety and stress. Very occasional use... Every 6 months :) Thanks for your input.

[homonculus]

Beta blockers such as these have been used for decades to manage anxiety. A London orchestra - I think the LPO but may be mistaken - all took them for a year. Their reviews crashed. The problem is that they reduce performance. People become lethargic and less concerned about excellence. If you take them on the flight deck IMHO you are a danger..

Of course the same drugs are used for hypertension, but only under prescription. Taking them for anxiety IMHO is wrong. Moreover if you take them you will have to declare this to your AME who may well tell you to come back at a later date once they have cleared your body. Failure to declare you have taken them is a serious offence and not only risks loss of your license but also potential prosecution.

Most AMEs are well aware and can cope wi white coat syndrome. Just be honest

[tommy4931]

Thanks for your reply. I wouldn't take them while flying, just on AME visits though... How could thy tell if you took a single dosage?

[homonculus]

You would have an abnormally slow pulse

But that isn't the point. If you pass your medical by cheating and take drugs that you conceal you have committed an offence and your medical is invalid. If you then fly you are flying illegally. Not only are you liable to prosecution but your insurance is invalid.

[tommy4931]

Thanks for your answers. Better safe than sorry....!

[gingernut]

I prescribe beta blockers for anxiety-as with all these things, some patients do really well, others don't. It's usually a matter of trial and error. They seem to be useful at "mopping up" the physical manifestations of anxiety, fast heart rate, sweaty palms feelings of panic etc.

In answer to your question, its likely you'll get away with it, but as my learned colleague points out, sinus bradycardia could trip you up either on physical examination or on ecg. (Quite common). If detected, you could be opening a can of cardiological worms unless you own up to using them.

Potentially, bronchospasm, although rare, could either kill you, or at the very least, affect peak flow.

The act of blatant deceit is perhaps the most worrying thing though:)

[tommy4931]

Thanks for your input. There's always more to something than you think. Thanks. I've never failed a physical, but I'm always nervous when I go in. My intentions were not to deceive the doctor to pass the medical, just make it a more tolerable event.

[gingernut]

Tell him how you feel.

Then continue to pass each time:ok:

[JustOnePilot]

I was thinking of getting a prescription of inderal for public speaking, only for one event.. Couldnt find any information if inderal is permitted or not? At the moment my medical has lapsed but I certainly want to renew it in the future.. Am I going to have any problems when they see that I have used it earlier? Thanks!

[tommy4931]

The pilot I flew with said inderal was a god send for anxiety when he had to give presentations. He said you can't fly on it but never alluded to it being a problem with his AME.

[ElNull]

I have the similiar situation and was thinking about taking propranolol/inderal to calm me down before my AME, I become very anxious when it is my turn for the cardiology exam and concequently my heart rate and blood pressure spikes. I really need your opinions. Thanks!

[ShyTorque]

I was prescribed propanol for a while about twenty years ago. I was grounded. Say no more.

[ElNull]

I was prescribed propanol for a while about twenty years ago. I was grounded. Say no more.

Hello! Thanks for your reply! Why you were grounded though?

[Loose rivets]

What is it about, Say no more, that you don't understand? Nudge nudge. Wink wink. :p

[ElNull]

What is it about, Say no more, that you don't understand? Nudge nudge. Wink wink. :p

I’m not going to take propranolol regularly. I only want to take it only once before my AME for my anxiety which I cannot control.

[ShyTorque]

It’s a requirement to declare any medication on the form that you are required to sign at the time of the medical. If you don’t you are falsely gaining a certificate.

[Fostex]

I’m not going to take propranolol regularly. I only want to take it only once before my AME for my anxiety which I cannot control.

It is more sensible to discuss any 'white coat syndrome' with the AME prior to the appointment rather than secretly medicating oneself in an attempt to alleviate the symptoms.

As Gingernut says it is better to avoid starting down this road as it may start a pattern of normalising this behaviour in your day to day life.

[ElNull]

It is more sensible to discuss any 'white coat syndrome' with the AME prior to the appointment rather than secretly medicating oneself in an attempt to alleviate the symptoms.

Thanks for your answer. It is indeed more sensible to discuss white cost syndrome with AME but it is definitely not effective and wont be of much help in my case. Again, it is not an easy thing to control, and in the end it is an exam that you can only pass by meeting specific requirements, it is not a usual doctor appointment that you can take it more easy.

[parkfell]

White coat syndrome might be helped by exercise in the gym before the medical.
Not as a one off, but part of your regular daily routines.
Get on a really good sweat, open up the arteries, and you will present with lower blood pressure, and might even feel more relaxed by doing so. Even more so on future visits.
This is a far better cure than medication which you fail to declare.
If that isn’t to your liking, arrange to see a Trick Cyclist, as there might be a deep underlying cause.
The UK CAA recently successfully prosecuted someone who was attempting an initial class one, and failed to declare some previous relevant medical history.

[421dog]

When a fat guy presents to me with a pulse of 46 and a BP of 100/60, I’m pretty sure what’s going on, and it’s not uncommon...
Hypertension in the US is a CACI, as long as the airman is controlled on less than 3 drugs, so all I need as an AME is a note from his doctor saying he’s asymptomatic on his current med regimen, and we’re good to go for any class medical. Why lie?

[Fostex]

On the other hand I once knew an anaesthetist who took propranolol daily in order to do her job as she suffered from a benign essential tremor (congenital shaky hands). An indication perhaps of the differences between occupational heath regulation in aviation and medicine.

[421dog]

On the other hand I once knew an anaesthetist who took propranolol daily in order to do her job as she suffered from a benign essential tremor (congenital shaky hands). An indication perhaps of the differences between occupational heath regulation in aviation and medicine.

benign essential tremor is not a disqualifying condition, and I’ve given a bunch of certificates to pilots with the problem who are on beta blockers for it...