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Teen Student Pilot with history of anti-depressants
My neighbor's son is enrolled in a high school aviation program and his goal is to acquire his PPSEL and then pursue aviation through college or academy and work professionally as a pilot. But he is an adoptee from Russia and early in his life (from grades 3 through 10), he was being treated by various psychiatrists for anxiety, depression and even PTSD using the popular anti-depressants (most of which are on the FAA no-go list). Eventually he was diagnosed with PANDAS and his treatments began to swing away from depression/anxiety/PTSD meds, and he has been off those meds for 6 months and doing well. His current psychiatrist has stated he shows no signs of PTSD or depression and has not prescribed additional meds.
He is a remarkably bright kid, achieving top grades, and very driven to succeed. When I think about where this boy began his life, and the circumstances he's endured, it is remarkable how well-adjusted he actually is. He is learning the material at an alarming rate to the point where his instructor wants to bump him to the Senior class level, But this will require him to obtain his FAA medical sooner than expected. He and his mom (who has confided all of this in me without having a dad in the picture) were thinking they'd like a little more distance between the anti-depressants and his FAA Medical application. I promised her I would inquire here whether it makes a difference that he was on these meds at such a young age or if having time off the meds without a recurrence is a good thing. Does he have a shot at all at getting a medical and continuing his training toward a professional pilot career?
Thanks for your collective advice and sensitivity.     
4 Replies
1218 Posts
This condition appears not to be in the FAA's AME guide.  Definitely a question for Bruce Chien.  But for most psych conditions, the more time off meds without symptoms or recurrence is generally better.
Thank you. Their sense is to put some distance between his FAA medical and his last anti-depressant use. And also to get a psychiatrist to formally document his stability and how long he goes without needing any meds.
I chatted with the boy's mom again yesterday. It sounds like, since the 3rd grade (shortly after his US arrival), doctors were trying to diagnose some of his behavioral issues and just started trying PTSD, anxiety and depression therapies with lots of prescription drugs, some of which are not intended for children. Her sense, and that of the boy's latest pychiatrist, is this onslaught of meds merely created some of his later behavioral challenges as he grew up. 
Maybe Dr Bruce will chime in next. Much appreciated. 
1218 Posts
If Bruce doesn't show up here, try his web site
Paul, there are two critical factors:

(1) whether or not there was ever a discontinuity in the treatment and he had to restart (criteria for recurrent illness) and
(2) Where he was ever on more than one antidepressant at once.
(3) If there was ever any suicidality.

These are UBER important to know before any discussion is begun.....and yes, though some distance is likely better, he many not have that option AT ALL.

The ultimate period is 10 years of well documented no events, no meds, and well documented successful life test.  That is the FAA informal unwritten standard for reconsideration of diagnoses though to be recurrent.  Important, because FAA denies (pretty uniformly),  "recurrent disease unmonitored and untreated".

The psychiatrist is needed to document what his history really, is about and to put a DSM-4 diagnosis,  that is accurate upon it, as well as to document the "current state".  FAA hates "diagnosis not given", or the family practitioner's simplistic "anxiety" diagnosis.