On the official list of side effect of Zoloft especially one says it all:
“severe mood or mental changes”
https://www.drugs.com/sfx/zoloft-side-effects.html
Happy flying.
(In Denmark SSRIs are commonly called happines pills)
(2) have commenced the regular use of any medication;
I’d read that slightly differently, with particualar emphasis on “regular use”. Taking anitbiotics for a week or two wouldn’t be “regular use” in my book, but rather temporary use.
To me “regular use” implies some form of long term use.
dublinpilot wrote:
Taking anitbiotics for a week or two wouldn’t be “regular use” in my book, but rather temporary use.
I think any condition which requires taking antibiotics for “a week or two” will clearly fall under point 4 of the list quoted above:
(4) have been suffering from any significant illness involving incapacity to function as a member of the flight crew;
A couple of years ago (EASA regulations were already in place) I went through the medical questionnaire with my AME during the yearly visit. Before, one would fill the questionnaire on paper for oneself while waiting for the doctor, but now it has become an eye-to-eye interview with the doctor ticking the boxes on his computer screen. So when he asked about any medication during the last 12 months, I told him that I got myself a vaccination against tick-borne encephalitis (we live in a high risk region and I spend much time outdoors). So he lectured me that I should have informed them immediately and next time better go directly to him for any vacccination…
Peter wrote:
Obviously (b) is a real catch-absolutely-everything, including the common cold…
… or indeed a tooth filling. 
Which is surely beyond parody. So it is left to the “soft law” AMC to temper the “hard law” idiocy with a measure of reason:
AMC1 MED.A.020 Decrease in medical fitness
If in any doubt (my emphasis) about their fitness to fly, use of medication or treatment:
(a) holders of class 1 or class 2 medical certificates should seek the advice of an AeMC or AME;
(b) etc…
With my tongue only very slightly in cheek, I think I know a safe alternative to psychotropic drugs in aviation. For many of us here, flying is the best remedy for depression, anxiety or moodiness. If you don’t feel well enough to fly on your own, do a few flights with a safety pilot until you recover, and then keep flying as often as you can!
Michael_J wrote:
“Patients who take selective serotonin reuptake inhibitors (SSRIs) such as Prozac (fluoxetine), Paxil (paroxetine) or Zoloft (sertraline) may experience side effects such as violent behavior, mania or aggression, which can all lead to suicide.”
I see where you’re coming from, but these side-effects are most likely in the first month or two after starting the drug. One theory goes that when people are feeling very low they simply can’t be bothered to kill themselves; SSRIs may increase motivation before they relieve the depression. Another possibility is that people who actually have bipolar disorder (‘manic depression’) rather than ‘regular’ depression can react very badly to them – again you’d hope to discover this early on. Also they sometimes make people feel worse (more anxious, twitchy etc) before they start to make them feel better. A few years ago there was a big scandal about suicide in teenagers and whether the drugs companies were entirely open about how much they knew about this. The drugs are felt to be particularly risky in this age group.
The FAAs 6 month delay between starting the medicine and resuming flying will be intended to allow the dust to settle so a patient’s response to medication can be properly assessed after the riskiest period of initiation of therapy. Even if a lot of questions remain as to how effective they are, how they change cognition and suicide risk they are at least amongst the better studied drugs and the answers will be bracketed if not always known.
I’m not sure exactly what you mean by ‘careless syndrome’ but depression can certainly reduce alertness, IQ, attention to detail as well. Medicine is all about balancing risks and benefits; SSRIs have risks. Untreated or undertreated depression has risks. Often it takes a while to find the right treatment, or for people to work their way to a better place. Sometimes psychological distress is mistreated, over-treated or over-medicalised, but on the other hand serious depression sometimes responds very well to drugs, and they are appropriate. The most important thing is to avoid becoming isolated and keep talking to people.
With my tongue only very slightly in cheek, I think I know a safe alternative to psychotropic drugs in aviation. For many of us here, flying is the best remedy for depression, anxiety or moodiness. If you don’t feel well enough to fly on your own, do a few flights with a safety pilot until you recover, and then keep flying as often as you can!
I couldn’t agree more… depression can run in families genetically (Buzz Aldrin being one of the better known ones) but most of it is lifestyle related. My GF is a nutritionist… the patterns in this stuff (relationships → obesity → problems at work → obesity → low self esteem → depression…) are usually visible from a long way away. The person himself/herself has to break the circle. Drugs seem to rarely work, especially in the longer term. My ex was on them too, but she had it from her teenage years. I have seen so much of this among people I know or have known.
flying is the best remedy for depression, anxiety or moodiness. If you don’t feel well enough to fly on your own, do a few flights with a safety pilot until you recover,
On the other hand if you don’t feel well enough to fly on your own, should you impose your instability on another pilot?
I recall an incident many years ago of a mentally unstable passenger flying with the pilot of a C172, who simply opened the passenger door and jumped out of the aircraft mid flight.
what_next wrote:
A couple of years ago (EASA regulations were already in place) I went through the medical questionnaire with my AME during the yearly visit. Before, one would fill the questionnaire on paper for oneself while waiting for the doctor, but now it has become an eye-to-eye interview with the doctor ticking the boxes on his computer screen. So when he asked about any medication during the last 12 months, I told him that I got myself a vaccination against tick-borne encephalitis (we live in a high risk region and I spend much time outdoors). So he lectured me that I should have informed them immediately and next time better go directly to him for any vacccination…
On what basis did he expect that? I can’t see anything there that would require notification of a vaccination. Indeed I’ve had the tick-borne encephalitis vaccination myself a few times, and it never occurred to me to report that to the AME. I don’t think there was anything on the questionnaire about vaccinations either.
I think he was overstepping the mark and looking to drum up business. If it was me, I wouldn’t use them again. I never had any such problems with me AME.
dublinpilot wrote:
I think he was overstepping the mark and looking to drum up business.
Maybe you are right. Luckily I don’t have many vaccinations coming the next two or three years.
dublinpilot wrote:
If it was me, I wouldn’t use them again.
If there’s one thing I learnt in my years in aviation then it is “never change your AME unless there is no other option”. A lot of pilots I know (including myself) got into quite some trouble after moving to a different doctor. As long as he signs my medical every year I would be foolish to try my luck and go elsewhere…
