MEDicaL
Q&a
ELaTiON abOuT DEPrEssiON!
(…well, maybe just a big smile)
For years we’ve asked the question of which was safer, an airman flying on a reasonably safe medication with a completely moni-
Dr. Phil
PArker
tored and stable medical condition or an airman that is not seeking
treatment for an extremely common condition for fear that it would end their aviation career
as there are no options to waiver the medication? On April 2, 2010, the FAA answered the
question with release of the Federal Air Surgeon’s new poli-
cy on medical certification of pilots with depression treated
with medication and who require ongoing treatment with an-
tidepressants. The new policy will allow some pilots with de-
pression which has been adequately treated with medications
to hold any class of medical certificate with a Special Issu-
ance Authorization (SIA). Our physicians have advocated for
a change in this direction since 2002, and we believe this is a
very important step to enhance aviation safety and improve
pilot health. Note that the prior FAA policy to grant waivers to
those pilots and controllers whose condition remains in remis-
sion off antidepressant medications for at least 90 days was not
affected by this new policy.
The Good News
Pilots who have taken one of four medications, Fluoxetine (
Pro-zac); Sertraline (Zoloft); Citalopram (Celexa); or Escitalopram
(Lexapro) for at least 12 months and are stable on the medication may apply for an SIA. The diagnoses eligible for SIA are
limited to Major Depressive Disorder (mild or moderate) either
with a single episode or recurrent, Dysthymic Disorder or Adjustment Disorder with depressed mood. They must be on a
stable dose of a single medication that has ameliorated their
symptoms without aeromedically significant side effects or exacerbation of symptoms over the previous 12 months.
The FAA policy also includes a period of time up to
September 30, 2010, during which pilots who have previously failed
to report on FAA form 8500-8 (medical application) their use
of antidepressant medication or visits to physicians for depression have an opportunity for disclosing this information
without risk of prosecution by the Department of Justice or
administrative/enforcement action by the FAA. After September 30, 2010, the opportunity is gone. The forgiveness period
for failure to report diagnoses, use of medication or health
care provider visits is limited to psychiatric conditions and
not other diagnoses or treatment.
The Process
In order to take advantage of the “non-enforcement” period
for failure to previously disclose, airmen must relinquish their
medical certificates without guarantees that they will receive
a medical “waiver” or SIA. They must also not falsify an ap-
plication during the six-month “non-enforcement” period.
Who is Left Out?
This policy does not apply to Air Traffic Control Specialists at
this time. The Federal Air Surgeon anticipates a similar policy
for ATCSs after internal coordination with the FAA and external coordination with National Air Traffic Controllers Association (NATCA) at some point in the future.
Pilots that have psychiatric diagnoses of :
• Psychosis
• Suicidal ideation
• History of electro convulsive therapy (ECT)
• Treatment with multiple antidepressant medications
concurrently
This information is adapted from an article
by Dr. Quay Snyder in our office.
