Advice for SSRI path 1
Votes
Answered By AOPA

A quick breakdown of my history, I took 10mg of Lexapro from April 18-2021 for mild generalized anxiety. The start of 2021 I reduced to 5mg, by November 2.5mg and January of this year I was off totally. I've been off now for about 5 months and have an appointment scheduled with my local AME in June. I have gathered a letter from my treating physician stating my history and that I am now in great health. I have written a personal letter. Is there anything else I should have before going in? Has anyone gone through the SSRI path 1 before? 

11 Replies
Votes
AOPA Staff Answer

      For clarification purposes, not all pilot on a SSRI would be disqualifies for Basic Med. The regulation states that to qualify for Basic Med a pilot cannot have developed the following since their last FAA medical certificate 

  • A mental health disorder, limited to an established medical history or clinical diagnosis of—
    • A personality disorder that is severe enough to have repeatedly manifested itself by overt acts;
    • A psychosis, defined as a case in which an individual —
      • Has manifested delusions, hallucinations, grossly bizarre or disorganized behavior, or other commonly accepted symptoms of psychosis; or
      • May reasonably be expected to manifest delusions, hallucinations, grossly bizarre or disorganized behavior, or other commonly accepted symptoms of psychosis;
    • A bipolar disorder; or
    • A substance dependence within the previous 2 years, as defined in §67.307(a)(4) of 14 Code of Federal Regulations
    • This includes:
      • Personality disorder that is severe enough to have repeatedly manifested itself
      by overt acts.
      • Psychosis, defined as a case in which an individual:
      >> Has manifested delusions, hallucinations, grossly bizarre or disorganized
      behavior, or other commonly accepted symptoms of psychosis; or
      >> May reasonably be expected to manifest delusions, hallucinations, grossly
      bizarre or disorganized behavior, or other commonly accepted symptoms of
      psychosis.
      • Bipolar disorder.
      • Substance dependence within the previous 2 years.
      Furthermore, the FAA’s new medical rules do not apply to an individual with a clinically
      diagnosed mental health condition if, in the judgment of the individual’s state-licensed
      physician, the condition:
      • Renders the individual unable to safely perform the duties of or exercise the privileges
      of a pilot in command of a small aircraft under the FAA’s new medical rules;
      • May reasonably be expected to make the individual unable to safely perform the duties
      of or exercise the privileges of a pilot in command of a small aircraft under the FAA’s
      new medical rules; or
      • The individual’s driver’s license is revoked by the issuing agency as a result of a clinically
      diagnosed mental health condition."

There is no mention of the use of a SSRI being prohibited and requiring a Special Issuance prior to obtaining Basic Med. What it states is that if the pilot is found to have developed the above, then they would not be eligible for Basic Med and would require a FAA Special Issuance first.

I would recommend calling AOPA Medical Certification for any Basic Med questions you may have.

 1-800-872-2672 #3 

 https://www.faa.gov/licenses_certificates/airmen_certification/basic_med/

Votes
1433 Posts

Many people have done it, pretty much all under the advice of an expert on the issue like Dr. Bruce Chien (www.aeromedicaldoc.com).  Or contact the AOPA Medical Help desk for advice.  You need your submission to be 100% approval ready, because otherwise the process bogs and your chances of approval sink.

Votes

I am doing the same thing, but with a different SSRI. I was off for over 90 days on the day of my medical (last Friday), and I'm waiting for my AME to transmit the exam. My primary car physician says I'm fine, as I went on it nearly 30 years ago and have not had an incident since. I hope this works for both of us.

Votes

I last took an SSRI nearly two years ago and I am scared to go for a regular medical certificate.  I have been unsuccessful getting a letter from my treating physician at the VA.  They either don't understand or just won't do it.  The last thing I want is another appointment with the Doctor just to get this letter.  I do not want to ell the FAA I had another psychiatrist appointment recently.

I haven't flown in 5 years and miss it so badly I am going to go BasicMed this time.  Once 3 years hits next year, I won't have to tell the FAA about the SSRI any more and I will relax about the medical certificate I think.

Votes
1433 Posts

David Burnworth: 
I haven't flown in 5 years and miss it so badly I am going to go BasicMed this time.

That's not an option.  See 14 CFR 68.9(a)(1).  With a mental health disorder (and the FAA considers anything that involves taking an SSRI to be a “mental health disorder”), you must obtain a Special Issuance for that disorder before you can apply for Basic Med.

  Once 3 years hits next year, I won't have to tell the FAA about the SSRI any more and I will relax about the medical certificate I think.

Question 18 covering your medical history says “Have you ever in your life…”, not “Have you in the last three years…” and the “mental disorders” question is 18m.  It is question 19 on visits to a health practitioner which involves only the last three years, not question 18 on your medical history.  If you lie on this and the FAA finds out (which they eventually will), they will at a minimum revoke all your FAA certificates (pilot, medical, whatever), and may turn it over to the Department of Justice for criminal prosecution under 18 USC 1001 (which can involve hefty fines and even jail time – ask Martha Stewart).

Votes
1433 Posts

Vampiress At AOPA: 
 

There is no mention of the use of a SSRI being prohibited and requiring a Special Issuance prior to obtaining Basic Med. What it states is that if the pilot is found to have developed the above, then they would not be eligible for Basic Med and would require a FAA Special Issuance first.

Vampiress is correct about the regulatory language.  However, as I said before, there is no condition for which an SSRI may be prescribed which the FAA does not consider to be a “mental health” condition in this context.  So if they find out you took an SSRI in the past, they are going to demand that you prove you you did not/do not have a disqualifying mental health condition before issuance of a medical certificate or going Basic Med.  It's like Ritalin: doesn't matter why you took it back when you were eight years old -- they assume ADHD and won't issue unless/until you prove you either never were or aren't now ADHD.