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Quandary about SSRI's

Old 28th Jun 2017, 13:23
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Quandary about SSRI's

Hello,

I am suffering from mild depression/anxiety which affects my daily life, especially in school. I am seeing a psychiatrist and he suggested me to get SSRI's. Me and him have been researching is it possible to get a initial Class 1 Medical (unrestricted) while taking SSRI's. We found that it IS possible to fly under taking them, but the process isn't familiar with us.

Would anyone know something about the process of getting the medical under SSRI's? We've tried to comply with the Depression flow chart by the CAA, but we don't understand the process with initial applicants. Any help is appreciated.
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Old 28th Jun 2017, 15:12
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I only have knowledge of the UK CAA depression protocol https://www.caa.co.uk/WorkArea/Downl...?id=4294973468

From this, as far as I can see, active treatment with an SSRI requires an OML (operational multi crew limitation). Another thread on this site (http://www.pprune.org/medical-health...ass-1-oml.html) suggests that initial certification with an OML is not possible under EASA.

I do not have any information about how the Spanish CAA handle this medical query. You may wish to contact your particular national regulator.
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Old 28th Jun 2017, 16:28
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So it's a straight no from the CAA if I'm under SSRI's and I am applying for a Class 1 Medical?
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Old 30th Jun 2017, 22:20
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And you will need to declare what will be your previous condition once you come off the medication.
You will need to demonstrate you are fully better and will remain so.
Perhaps you need to wait at least 12 months
And be prepared to be referred to an appropriate specialist prior to the issue of the initial class one.
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Old 7th Jul 2017, 14:04
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Clinicians don't commence these lightly, however sometimes, there are other therapeutic choices available.

Would certainly be worth making your doc aware of the implications on your future career.
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Old 7th Jul 2017, 19:39
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Hi there. It's good that you are open and honest about your condition and i'm glad you're getting the help you need.

I'm not a doctor, but know of alternatives to SSRI's, and so there might be some things you could discuss with your doctor. There are things like St.Johns Wort and 5-HTP that you can take, which are over the counter herbals and supplements respectively. 5-HTP boosts (or is said to) serotonin levels in your brain; although it doesn't cure depression (although neither do SSRI's), they merely make it more manageable. I've heard of people taking SSRI's etc, which make it more manageable to the extent where they can receive other treatment like CBT (cognitive behavioural therapy) which works for some people with Anxiety/Depression. Online CBT can be accessed from a site called MoodGym (they're based in Australia). Other things like a high omega 3 diet, getting plenty of sunlight, surrounding yourself with good people and meditation are also said to help.

Not sure what you're standpoint is in a Class 1 perspective, but I know a lot of people with Anxiety and Depression and can only advise on help managing your condition - although everyone is different - but if it helps then thats excellent.

Best wishes through your recovery
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Old 8th Jul 2017, 22:15
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St John Wort has some serious side effects; not better just because it is "natural"!

(Remember: the "natural" sting from an otherwise totally eco friendly bee might cause death, so...)
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Old 9th Jul 2017, 12:09
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Of course, much agreed. Although it's just an area worth considering and worth a chat to the doctor about, many people swear it's helped them. But quite right, different people react differently to different thing, hence proper medical advice should be received.
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Old 20th Jul 2017, 15:06
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Be very careful with St Johns Wort. If up the liver enzymes, causing it to interfere with the metabolism of any existing medication you may be taking.
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Old 28th Jul 2017, 14:29
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and I think St. John Wort its not compatable with with the oral contraceptive!
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Old 28th Jul 2017, 15:25
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However being more serious, I thought SSRI were allowed in the UK and USA, but that was a while back, and as someone stated it is very positive that you are open about you mild depression.

My concern for you would be that following Germanwings, different aviation authorities and airlines might take different approaches and might find yourself spending alot of money and not finding a job, sorry to be negative.

But being on the positive side, if you can avoid SSRI you should. I would say and I tend to take the opinion that Psychiatrists are more likely to resolve matter through medication, where as Clinical Pschologists tend to resolve matters through talking therapies. I wouldn't have though in the UK you would get a NHS referel to a Psychiatrist for mild depression.

My thoughts are that about 40% of the population experience mild depression in any year, including pilots, so if you can sort this in other ways other that SSRI's. I think you sound young enough to sort your issues without SSRI's.

While I'm not convinced with herbal medicines, I not saying you should not. My suggestion are to consider the following:

(a) Regular vigarous excercise such as running, cycling, rowing, tennis, because exercise increases the'happy' drug in your mind, this is documented This is recommended by some doctors in the UK rather than SSRI's.

(b) Consider a taking therapies through a registered councellor or clinical psychologist.

(c) Buddist Meditation as that includes positive thinking, the are groups in most cities.

(c) On the subject of positive thinking, because I would say alot of people with depression think negatively, read the the book, Don't sweat the small stuff, as it's all small stuff, I have forgotton the author so google it.

(d) Eat heathily and take multi vitamins daily.

(e) Remember drinking too much alcohol, which is a depresant, can cause depression, so drink less or cut it out.

(f) Download the The Holmes and Rahe Stress Scale, and complete it as this will give your cumulative stress rating out of a hundred and give pointers to how you identify ares of stress in your life.

PM me if you need any more help.

Last edited by Homsap; 28th Jul 2017 at 19:05.
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Old 28th Jul 2017, 16:07
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Medical standards and practice vary between CAAs, especially with mental issues. The standards are generally available on the web, but how they are interpreted can vary. Your national Owners and Pilots Association might have a medical panel that would be very worthwhile contacting.

Certain diagnoses can preclude your ever flying in particular countries.
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Old 28th Jul 2017, 18:09
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I should add to my previous post Neuro Linguistic Programining (NLP) or accupunture, might be an option, yet to be honest I really don's know alot about it, but an CAA AME class 1 practises therapy in both these areas at BHX, google it (SL).

Last edited by Homsap; 28th Jul 2017 at 18:56.
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Old 28th Jul 2017, 23:31
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SL retired a year ago.

@ TS - your main focus needs to be on getting better. Taking on the stress of getting a medical, doing ground school and flying would unlikely be helpful in recovering from your depression.

Once your depression has resolved and you want to go flying you will need to do some research and find out what your options are. Your details suggest that you are in Spain but you have looked at the UK CAA's guidance.

You can get a medical from any EASA competent authority but you have to bear in mind that your training organisation must be aligned with the EASA competent authority which has issued your medical certificate.

So a UK medical and a Spanish training organisation does not work.

A UK medical and a UK training organisation would, as would Spanish and Spanish.

And finally, the vast majority of folks on these bulletin boards post here to help people bringing questions or issues they want to discuss. But bear in mind that some people may have more knowledge than others and that not all suggestions are based on a scientific or accepted practise basis.

There is a good reason that the header of this particular forum reads:

Any information gleaned from this forum MUST be backed up by consulting your state-registered health professional or AME.
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Old 1st Aug 2017, 19:47
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Perhaps the best cure for depression is doing some outdoor activity you enjoy. Those that involve participating with other people are even better.

Tennis, hiking, cycling, sailing, cricket, football....
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Old 28th Oct 2017, 12:20
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Has anyone else come off of SSRIs and gone through the process for getting a class 1 back in the UK? Did you need to visit the 'Belgrano' for an assessment or did the AME cover all the box ticking?

PMs are fine if you're concerned about anonymity.
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Old 29th Oct 2017, 18:48
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Have had several pilots class 1 and 2 who have either been on one of the approved SSRIs and returned to flying whilst on the medication and/or returned to flying after coming off the medication.

The full guidance is available on the CAA website which includes a flow chart with the steps to go through.

Your AME would be your first point of contact.
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Old 30th Oct 2017, 18:47
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Thanks, but I've started going down that route over the last 6 months or so. What I'm after is some ideas of how long the process is in reality, rather than just guessing at whether the Paperwork or the bank account will be finished first, if you see what I mean.
I seem to be fine in the Sim and the GP is happy that there are no side effects or other concerns (HAM-D below 6).
So, how long between "Cured" and putting on the cheap suit again?
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Old 1st Nov 2017, 10:36
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Your treating physician needs to supply the AME with a report, answering all the items on the CAA template for this, that needs to go via your AME to the CAA.

They will then invite you to come and see their psychiatrist.

If they are of the opinion that you are fit to return to flying they will report that to the AME and they can sort out your flight status.

Commonest issue is that that report to the CAA does not address all items and you then end up in a bit of a loop until that is sorted, and there can be a bit of a wait for seeing the CAA psychiatrist.

So how long will it take is difficult to answer.
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