PDA

View Full Version : Depression, Wellbutrin, Safety & Life


Flyer3
16th May 2003, 05:48
I am rather peeved that the FAA seems to regulate our lives in an illogical manner. I have a friend who sometimes suffers from periodic depressions. (Not the bipolar manic depression nor the lifetime blues...simply depression-an organic, treatible depression.)

I saw this guy grow so much while getting his Private Pilot's License. He was so animated when he'd return from his lessons. It was really good to see him journey through his accomplishments, facing his fears and climb over his walls. He found what we all could see was "what he loved." We all want that. He would however still get depressed and it really slowed him down.

He went to an MD who suggested he try wellbutrin. The doc told him it might alleviate the depression and that some reported that it helped them to concentrate better. He tried the wellbutrin. It seemed to give him renewed energy and many noticed he was happier. That is great. He went on to get his Instrument Rating while he was on wellbutrin. He passed his check ride and was a happy camper. The Doc tells him he should probably stay onthe meds indefinately. Why go on and off of them if it'll slow down his life? Then my friend finds out it's illegal to take antideppressants and fly. Now he doesn't fly. He wants to fly, he really wants to go for his Commercial, teach, maybe work for the airlines...the whole nine yards. Flying woke this guy up. It gave him so much...

I wonder...he went through all his instrument training, passed the tests, everything. He didn't do anything dangerous that I heard about. Certainly his instructor and the examiner didn't see anything dangerous. The medicine probably made him safer.

Depressed pilots are probably not as safe as people in a better mood state. Certainly, there have probably been pilots who have committed suicide (or almost, sick as it sounds) in an airplane. But if they had gotten treatment and weren't depressed they wouldn't go there. So what's the point? Fly depressed or get treatment?

I'm sure there are depressed pilots. I would rather be flying with one that was getting treatment than one who was slugging it out up there depressed. That is ridiculous if you ask me. I'm sure there are pilots that take medicines that are safe, that don't degrade their ability to fly but DO enhance it. I'd wager my friend was safer flying while on wellbutrin than when he was depressed.

How many pilots continue flying while depressed? (I know it can affect your decision making, your reaction time etc.) Why would they? Because if they get medical treatment they'll be grounded. Doesn't make sense. The FAA I believe has that rule because they worry about the underlying problem. Me too. So treat it. But if the meds help a person to perform safer...why not allow those meds? Is wellbutrin dangerous...evidently not for my friend.

Come to think of it, I know a couple of people who don't fly because of this medical rule. I wonder how many still fly while depressed and how many are up there on these meds covertly. Some people have invested so much in their careers and then find they can't fly because they have to take a medicine that is safe but illegal. Doesn't wash with me.

Anybody know of organizations trying to work towards a more reasonable solution? Or what do you think?

TRF4EVR
16th May 2003, 05:56
If I were your uh *cough* friend, and if I were of a *cough* less law-abiding nature, I might just go ahead and fly on them without reporting it. That is. If I were your friend. And if it were legal. *cough*

ausdoc
16th May 2003, 06:09
The time will come when those with mild depression, suitably treated, will be able to get certification. It already happens in a few countries, including Australia.

What could be a problem is that if there is ever an accident, regardless of the cause, and a non-approved medication is picked up on screening or at autopsy, or the medical records are accessed by the courts, insurance will be voided, criminal charges may follow, etc, etc.

Better to be up-front about it.

Flyer3
16th May 2003, 09:54
So why do countries other than the US allow the use of certain antidepressants? In the US you can use them but you have to have been off them I believe for 3 months.

Thanks for the reply!

ausdoc
16th May 2003, 12:38
I think the reasoning is that it is probably better to have someone well controlled, on a suitable medication, and known about, than it is to have someone keep it a secret and be not on any treatment.

Flyer3
17th May 2003, 00:12
That seems most reasonable.

perrepilot
20th May 2003, 04:50
I agree with ausdoc. It is better to forbid flying with a depression rather than forbidding flying on treatment of a depression.

However, I feel a bit biassed saying this, since I kind of have a depression myself. I'm 17 years old and dreaming of working in the skies. I'm about to take my glider pilot's license.
I took seroxat for a while in automn last year, and that helped a lot! However I quit taking them after only about 1 1/2 month since I felt I could manage without them. After I quit, things slowly got worse again. Now I see a psychyatrist once a week, and I'm on seroxat again.

I wonder if anyone has any opinions on my dreams of becoming a pilot.. I know you got to be very motivated to get there and work hard, but it's not easy to work hard when you're depressed. How are my chances of getting a job in this extremely hard market, when my CV says that I has suffered from a depression?

thnx for any answers, and please PM me if you like.

Best regards,
PP

Notso Fantastic
20th May 2003, 05:01
Sorry to be blunt, but I don't believe depression and passenger flying mix period. If you have depression, if you are on anti-depressants, I do not believe you should fly and I don't want to be flown by you. There have been too many crashes intentionally caused by mentally ravaged people for my comfort. You must get the depression thing sorted out before flying.

QDMQDMQDM
20th May 2003, 05:37
Sorry to be blunt, but I don't believe depression and passenger flying mix period. If you have depression, if you are on anti-depressants, I do not believe you should fly and I don't want to be flown by you.

I agree 1000%. Apart from anything else, poor concentration is a cardinal sign of depression and the drugs themselves can impair psychological performance. Merely saying ' you might as well let people fly on anti-depressants because otherwise they'll just fly depressed and not report it' is not a reasonable argument to me. I see depressed people every day of the week and many of them I wouldn't trust to park my car.

QDM

Flyer3
20th May 2003, 08:36
I thought this might be of interest:





Summary Brief Abstract Citation ASN.1 MEDLINE XML UI List LinkOut Related Articles Domain Links 3D Domain Links Genome Links Nucleotide Links OMIM Links PMC Links Cited in PMC PopSet Links Protein Links SNP Links Structure Links Show: 5 10 20 50 100 200 500 Sort Author Journal Pub Date Text File Clipboard E-mail Order


1: Aviat Space Environ Med 2002 Nov;73(11):1094-9 Related Articles, Links


The impact of bupropion on psychomotor performance.

Paul MA, Gray G, Kenny G, Lange M.

Defence Research and Development Canada, Toronto, Ontario. [email protected]

INTRODUCTION: The NDRI (noradrenalin-dopamine re-uptake inhibitor) bupropion SR (sustained-release) is marketed as Wellbutrin* for treatment of depression or Zyban as a smoking cessation aid. There has been considerable interest in the possibility of returning aircrew to restricted flying duties once stabilized on bupropion SR after resolution of depressive symptoms, or while taking bupropion SR for smoking cessation. This study was undertaken to determine whether bupropion SR affects psychomotor performance. METHOD: There were 24 subjects (18 men and 6 women) who were assessed for psychomotor performance during placebo and bupropion SR treatment in a double-blind cross-over in counter-balanced order. Each treatment arm lasted 5 wk. The daily bupropion SR dose was 150 mg during week 1, and 300 mg during weeks to 2 to 5. Subjects completed a drug side-effect questionnaire and were tested on two psychomotor test batteries once per week during each of the placebo and drug arms. RESULTS: There was no significant Impact of bupropion SR on serial reaction time, logical reasoning, serial subtraction, or multitask performance. With respect to drug side effects there was a main effect of drug on "number of awakenings" (p < 0.048), "difficulty returning to sleep" (p < 0.004), and "dry mouth" (p < 0.049). There was no impact of bupropion SR on dizziness. DISCUSSION: While we found some of the expected side effects due to bupropion SR, there was no effect on psychomotor performance. These findings support the possibility of returning aircrew to restricted flight duties (e.g., in non-fast jet aircraft) under close observation once stabilized on bupropion SR.

Publication Types:
Clinical Trial

PMID: 12433233 [PubMed - indexed for MEDLINE]

--------------------------------------------------------------------------------

:8

(Many claim increased mental concentration.)


Frankly I think there are plenty of pilots out there that are depressed. I don't doubt some are fearful of losing their livelihood if they go for help. They risk getting grounded. The point is that a certain percentage of the population IS depressed and this does not exclude pilots. The prospect of getting permanantly grounded encourages pilots NOT to get treatment. Then you have depressed pilots flying. I'd rather have one up there that was getting treatment than not. What in fact do pilots do when they are depressed? I do not doubt many endure the pain.

What bugs me is if it's safe to take a medication why not do it? Why not legalize it? It is legal in some parts of the world. (I beleive ausdoc said it was legal in Australia.) Of course, the FAA allows you to take St John's Wart for depression and fly because it's not regulated. Seems to me this all needs further consideration.

perrepilot
26th May 2003, 00:35
Well, QDM, I have a little wierd form of depression. I get extremely self critical to everything I do, and I am not so good in social life because I believe everyone are better than me, so I just smile and talk **** and that makes me even more self critical.
It might be that I'm just growing up, but in automn I had a real breakdown and suicide thoughts and all, but no real attempts.

I love driving cars and almost all I've driven with have said that I'm a real good driver. My glider instructors also say that I'm good at flying as well, but I think they've noticed my problems.

So, I feel a little like the guy that Flyer3 was talking about. Should I start thinking about other career oppertunities or do you guys think I should go for it??

Happy landings,
PP

piper1
26th May 2003, 04:48
Some interesting points here....it's ok for you guys that are saying people suffering from depression shouldn't fly at all, due to lack of concentration and being slower to make decisions, but what about those night stops....you know the ones, v.late nights, far too much alcohol, away from base, dont pretend it doesnt happen! This goes on all the time and pilots are flying around happily believing that in this state they are safer than pilots suffering from depression...dream on!!