Addiction to Drugs/Antidepressants in Drug Tests
Iíve been dealing with depression for about five years now, but it has gone untreated. The reason for this is because Iím a pilot and if I put down on my application for my aviation medical exam that I have depression, my medical will be denied or I will have to wait 12 months from the medical exam to be reevaluated so that I can get a ďspecialĒ medical issued to me. I am currently to the point where I need to get this diagnosed and treated, but Iím afraid that my medical certificate will be suspended if they find out about my depression. I know that it isnít a good idea, but Iím hoping to keep it a secret from the medical examiner because I cannot lose my medical certificate for a year which will prevent me from flying. So my question is, during the urine (drug) test that is conducted during my medical exam, will any antidepressants show up making them aware of my depression? Will any give a false positive for something else for something else? Focus everything on Fluoxetine (Prozac), Sertraline (Zoloft), Citalopram (Celexa), Escialopram (Lexapro) because those are the four prescriptions that the Federal Aviation Administration has approved to treat depression. Thanks for your help.
(I have a son named Luke)!
Your question was one I took to heart. I have been drug tested multiple times over the years, as you might expect. First, please DO get your depression treated. I, myself suffer from chronic depression for a variety of reasons, and it can slowly and insidiously spiral into an unmanageable capacity. Some antidepressants are more effective than others, but nowadays most of the ones given are SSRIs (selective serotonin reuptake inhibitors) or SSNRIs (selective serotonin and norepinephrine reuptake inhibitors). These are far superior to what we had back prior to the middle 1980s for depression.
I know you didn't come to me for a pharmacology lecture, so I'll get right to the point. The short answer for you is NO. Most every over the counter drug and prescription drug, particularly antidepressants, are not considered a threat to your job. As you mentioned in your question, there are several that are acceptable to the FAA, and most of those you mentioned are SSRI or SSNRIs. Lexapro is a little different, but still acceptable I think. If, however, you should start a med and find that it affects your alertness, please report it to your doctor, and they will adjust it accordingly. You could perhaps take it before sleeping.
There are a few exceptions I should warn you about, but as long as you are honest and forthcoming on your questionnaire you should test fine. If, for any reason, you have a positive result, being a pilot they will retest you. Anyone knowledgeable at all with drug immunoassays should know that there are just a few OTC drugs which can show up as positive. I am speaking of decongestant nasal sprays (Afrin, oxymetazoline) and most specifically nowadays avoid Sudafed (pseudoephedrine). We know that it is used to manufacture methamphetamine, and that's why pharmacies have moved it behind the pharmacy counter. I had this happen to me about 15 years ago. I had three positive drug tests for amphetamines in a row! And, I have never, ever used amphetamines. It took some research on my part, and I came back and showed them that Sudafed did indeed contain a metabolite of amphetamines. I had been using it for a chronic sinus problem. However, 15 years ago they weren't so quick to believe me, so I nearly lost my job! I had to pay for the follow up urine tests myself, and go out of my way to prove that I was not using illegal drugs! Not even some of the MDs involved knew about this then. I mean, if they have the authority to test you and ultimately take your job, they should know what they're doing! Thank goodness things have changed!
Anyway, two things: Firstly, I want to honestly encourage you to see a professional right away for your depression. No one is immune from this dreadful condition. I will share this with you, though it's a little personal: I have had a terrible 4-5 years. A doctor gave me one of the "new" antidepressants about 5 years ago that was touted to be so effective, (as well as costly- a real money maker!) Well, it wasn't. So I went on this merry-go-round of different meds until two months ago when a new psychiatrist put me back on what I had been on before, Effexor, (Venlafaxine). I swear to you that within a week I started feeling more my old self again. And, it was not "all in my head". That particular med had always been effective and helpful for me. However, as I said, we are all different, so sometimes there is a trial and error involved in finding the right treatment. I wouldn't be a professional nurse if I didn't also suggest counseling or therapy. Together, there is hope for depression. So I am wishing you the very best.
I am pasting a website at the bottom of this note which gives some of the most comprehensive information I've seen on false-positives or false-negatives on drug testing. Just remember to be straightforward when the nurse or tech takes your history. You should have no problems. I would suggest not eating anything with poppy seeds for a week or so prior just so there's not a chance that any opiate metabolite should show up.
I applaud you for being so serious and diligent when it comes to your profession and faith which the public puts in you. When your physical and testing are all finished, I would be happy to hear back from you to see how it went. And, of course, I'm always interested in those that write in to me, so please let me know that you consulted a good psychiatrist and what became of that. There is help available, and I can attest that depression is a dangerous condition. God bless you, Luke. My thoughts are with you. SEE BELOW:
CLICK or go here: http://dig.pharm.uic.edu/faq/2011/Feb/faq1.aspx