DOT to allow truck drivers to drive while on antidepressants

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Washington (CNN) -- The Department of Transportation is changing a
generations-old policy banning drivers from taking antidepressants,
saying the new policy will improve safety by bringing to the surface
drivers who either ignore signs of depression or lie about their use
of medication for fear of losing their licenses to drive.

Beginning Monday, drivers with mild to moderate depression will be
allowed to drive while taking antidepressants if they can demonstrate
they have been satisfactorily treated for at least 12 months.

The DOT also will begin a six-month amnesty period, during which
drivers who use antidepressants can step forward without fear of
penalties. The drivers will be suspended until they can demonstrate
they have been stable for a year, although those who can prove a
history of successful medical treatment should be able to drive
"within a few months," the DOT said.
The new policy will "absolutely" improve safety, said Randy Babbitt,
head of the DOT and a former truck driver and union chief.

"The concern that we have today is we have people who are either self-
medicating or not seeking a diagnosis. Either of those is
unacceptable," Babbitt said. "This change ... will allow those people
to get the treatment, allow us to monitor and return them to the
driver's seat [as] safer, better drivers."

DOT officials said that they do not know the extent of depression
among drivers but that drivers are probably representative of the
larger population, in which 10 percent are believed to suffer from

Nor does the DOT know how many drivers have removed themselves from
driving status because they suffer from depression, a condition that
now bars them from driving. Nor do they know how many take
antidepressants in violation of DOT policy.

Commercial drivers under the age of 40 are required to undergo a
medical exam by an DOT-certified physician every year; those over 40,
every six months. But the examination focuses largely on the drivers'
physical health, and there is no formal assessment of the
drivers' mental health.

The DOT says drivers have a regulatory duty and professional
responsibility to not drive if they know they have a physical or
mental condition that makes them unsafe to drive.
But the DOT concedes drivers aren't always forthcoming, especially if
honesty could cost them their job.

"We know that there are people out there who are not taking
antidepressants because they know they would be suspended if they are.
We know there are people out there who are taking them and lying to us
about that," said Dr. Fred Tilton, the DOT's chief surgeon.
"We think it's safer to [make sure drivers are treated for depression]
than to continue to drive it underground," he said.

Under the new policy, the DOT will, on a case-by-case basis, issue
special medical certificates to drivers who take one of four
antidepressants: fluoxetine (Prozac), sertraline (Zoloft), citalopram
(Celexa) and escitalopram (Lexapro).

All four drugs can be used safely without side effects, the DOT said,
and other medications will be considered as the agency gains
experience and data under its new policy. DOT officials say that they
have been studying the issue for a decade, and that the change comes
with improvements in medication and as the stigma of depression has
diminished. One of the concerns is the risk of suicide by truck.
Between 1993 and 2002, there were 16 "vehicle-assisted suicides,"
according to a National Transportation Safety Board report, as
recounted in a recent DOT medical bulletin. All involved smaller

"Depression is a disease, and it's treatable just like any other
disease. And there is a stigma out there that we want to remove. We
want to make the skies safer, and we believe that this change in the
policy will benefit that and achieve that," Babbitt said.

Said Tilton: "We believe it's the right thing to do. We also have
support from all of the scientific organizations that understand the
treatment of depression and the safety of the airspace."
The new policy is consistent with recommendations from a host of
trucking and medical organizations, including the American Medical
Association, the International Teamsters Brotherhood Organization, the
trucking companies and consumer safety associations, the DOT said.
Babbitt acknowledged that drivers face some risk by stepping forward,
but he said they also face risk if they don't. "If it [unauthorized
use of medication] was ever discovered, it would be the end of their
license and their career, period," he said. The DOT said the policy
is being posted on the Federal Register, where the public can make
comments until May 3. Officials said because it is changing a policy,
and not a rule, pre-publication in the Federal Register was not