Citalopram and trainee driving positions

JAMES BENGE · 6 Jan 2020

Hi,

I feel a bit sketchy asking this but two questions.

1 - Do you have to admit you take Citalopram, if you didn't how could anyone ever find out?

2 - Should I not bother applying whilst being on these meds?

Everyone has problems in life and I don't want to feel ashamed of having to take a medication because life sometimes is a bit tough. I totally get the fact this is a safety critical job, I'm currently a class one HGV driver so yes I get the fact of safety but could me trying to better myself and my mind jeopardise me getting a job I've always dreamt of?

Any help would be truly appreciated.

RailUK Forums

43066 · 6 Jan 2020

JAMES BENGE said:
Hi,

I feel a bit sketchy asking this but two questions.

1 - Do you have to admit you take Citalopram, if you didn't how could anyone ever find out?

2 - Should I not bother applying whilst being on these meds?

Everyone has problems in life and I don't want to feel ashamed of having to take a medication because life sometimes is a bit tough. I totally get the fact this is a safety critical job, I'm currently a class one HGV driver so yes I get the fact of safety but could me trying to better myself and my mind jeopardise me getting a job I've always dreamt of?

Any help would be truly appreciated.

No reason to worry about asking a very sensible question. Mental health issues no longer carry the stigma they used to, thankfully. And neither should they!

The first thing to say is that yes, you will absolutely need to disclose it, along with any other medicines you might be taking, when you have your medical.

The good news is that depression in and of itself, and some types of anti depressant, are not disqualifying - in fact a surprising number of drivers take them.

That said there are certain anti depressants out there which cannot be taken by safety critical staff (usually ones which have drowsiness as a side effect, for obvious reasons). If the one you’re currently taking falls into this category it might be possible for you to move to another type which isn’t disqualifying (that’s something to discuss with your GP and/or occupational health department at your TOC).

Hope that helps and best of luck with the application process.

ComUtoR · 6 Jan 2020

JAMES BENGE said:
1 - Do you have to admit you take Citalopram, if you didn't how could anyone ever find out?

Yes.

You will be required to undertake a drugs screening before employment and also randomly whilst employed. If found to have undeclared medication, you are almost certain to lose your job and jeopardise any future employment.

Clip · 6 Jan 2020

Declare you r meds, declare your meds declare your meds.

Your mental health is not a barrier(in most cases) to gaining employment on the railway.

Lying about them are.

JAMES BENGE · 6 Jan 2020

43066 said:
No reason to worry about asking a very sensible question. Mental health issues no longer carry the stigma they used to, thankfully. And neither should they!

The first thing to say is that yes, you will absolutely need to disclose it, along with any other medicines you might be taking, when you have your medical.

The good news is that depression in and of itself, and some types of anti depressant, are not disqualifying - in fact a surprising number of drivers take them.

That said there are certain anti depressants out there which cannot be taken by safety critical staff (usually ones which have drowsiness as a side effect, for obvious reasons). If the one you’re currently taking falls into this category it might be possible for you to move to another type which isn’t disqualifying (that’s something to discuss with your GP and/or occupational health department at your TOC).

Hope that helps and best of luck with the application process.

Thank you very much, that has given me lots to think about. I guess going forward I need to find out which medication is prohibited. But in another sense as people we're all different, some drugs make people one way and some another. I have a medication review on the 28th of this month, no better time to ask I say.......... huge thanks once again.

GNER 91128 · 6 Jan 2020

Are you prescribed anything else apart from the Citalopram, like a PRN; something which you take as and when needed? SSRIs don't generally have serious side effects that prohibit ability to work and not considered "mind altering" unlike drugs like Diazepam and other benzodiazepines.

M84 · 6 Jan 2020

To be fair, what makes one person drowsy may not affect another.

If someone has been prescribed a benzodiazepine for over a decade for example and has no ill effects from it other than helping anxiety then surely they can't fail a medical because it "could" cause drowsiness.

I understand that many roles are safety critical but are medications not reviewed on a case by case basis or is there a definite prohibited list?

221129 · 6 Jan 2020

M84 said:
To be fair, what makes one person drowsy may not affect another.

If someone has been prescribed a benzodiazepine for over a decade for example and has no ill effects from it other than helping anxiety then surely they can't fail a medical because it "could" cause drowsiness.

I understand that many roles are safety critical but are medications not reviewed on a case by case basis or is there a definite prohibited list?

It's a blanket you can take this or you cant. You MUST declare any medication you take. Even once in employment.

ComUtoR · 6 Jan 2020

M84 said:
If someone has been prescribed a benzodiazepine for over a decade for example and has no ill effects from it other than helping anxiety then surely they can't fail a medical because it "could" cause drowsiness.

It isn't just about drowsiness or other side effects. There are other reasons why you need and should declare any and all medication. You have to think about it from a holistic approach rather than taking it on pure face value that X drug is or isn't allowed because of its 'side effects'

I understand that many roles are safety critical but are medications not reviewed on a case by case basis or is there a definite prohibited list?

Medications are reviewed on a regular basis; some drugs more frequently than others. There are a few that will absolutely remove you from safety critical duties and some that are prohibited for other reasons. The railway takes your health very seriously and it will often deteriorate by the very nature of the job. We are monitored within an inch and most, if not all, take failure of a med screen very seriously. This is not just about the drugs or alcohol side but is seen as a failure of trust. Not forgetting that you are legally bound with specific responsibilities when booking on. I have a 'safe list' on my computer but I would still need to declare anything I was taking or intending to take.

You are potentially responsible for thousands or passengers per day and that comes with certain responsibilities. We get paid a very decent wage and part of that is accepting the responsibilities involved. Declaring your medication is a tiny glimpse of the bigger picture.

Gemz91 · 6 Jan 2020

I take sertraline (100mg) and I'm a train driver. When I was first prescribed it had about three months signed off sick to ensure I had no side effects. I also got told on my last medical if I ever come off it, I'll be on light duties for 4 week for the same reason.

When my GP prescribed me she didn't think it would stop me driving temporary and was surprised when I told her. She suggested a couple of other meds I could take, but my occy health told me they were on the same list and would still require me to be on light duties/off sick. Think my point is, that if you talk to your GP, a companies occy health's opinion might be different from theirs.

Ferret · 6 Jan 2020

Contact the HR dept of whoever you’re applying to and find out - it’s easy enough for them to check what medication is ok to take and what is not. Honesty is always the best policy with regard to these situations.

JAMES BENGE · 6 Jan 2020

GNER 91128 said:
Are you prescribed anything else apart from the Citalopram, like a PRN; something which you take as and when needed? SSRIs don't generally have serious side effects that prohibit ability to work and not considered "mind altering" unlike drugs like Diazepam and other benzodiazepines.

No, I only take citalopram. I do not get any side effects at all. I've had many a medical review at work and passed them all.

ComUtoR · 6 Jan 2020

JAMES BENGE said:
I've had many a medical review at work and passed them all.

If it wasn't a railway occupational health review; it doesn't count. Different industries, different rules.

M84 · 6 Jan 2020

Does anyone have a prohibited list just out of interest?

notadriver · 6 Jan 2020

The side effects sound shocking to me

https://www.drugs.com/citalopram.html

ComUtoR · 6 Jan 2020

Because of the dynamic nature of medications no such list would remain valid for any extended period of time. Even the 'safe' list I have still categorically states that you need to declare. Also, you need to be aware that multiple medications will also have an impact on usage.

As for totally banned, and probably won't ever change.

Class A's, various Opioids, high strength painkillers, various recreational drugs, some heart medications, some anti-depressants, some antibiotics. Probably many more.

Again, I will reiterate that the medication itself isn't what specifically prevents you from being removed from safety critical duties. The railway is highly risk adverse. Medication restrictions are quite wide in their scope. If you have a medication who's side effect may include diarrhea, you are likely to be removed from duty. It will have an adverse impact on your duties. ANYTHING that could impact your day to day duty can get you removed from duty.

The only people who can definitively state that medication X is prohibited or can affect your duties; is Occupational Health. I know a Driver who is medically restricted because his medication is required to be taken at specific times of the day. He is allowed to shunt but is no longer allowed 'on the mainline' He is safety critical just severely restricted.

Declaring is your only option. Speaking to Occupational health is your only option.

I will also state that the TOC is allowed to take on staff with medical restrictions as long as they are prepared to accept that risk. Laser Eye surgery is a prime example of this. It is allowed within the standards but the TOC has to be prepared to accept that risk and have to adhere to further standards and restrictions. In an industry that is highly competitive, the slightest thing will tip the scales against you.

Always apply, always declare, is the way to go. Anyone thinking they could try and circumvent the system in any way, think that they might not get caught, want to hide anything, or generally believe that they know better; need not apply. Honesty, really is the best policy.

43066 · 6 Jan 2020

JAMES BENGE said:
Thank you very much, that has given me lots to think about. I guess going forward I need to find out which medication is prohibited. But in another sense as people we're all different, some drugs make people one way and some another. I have a medication review on the 28th of this month, no better time to ask I say.......... huge thanks once again.

No worries at all.

The way it works is that all medications must be notified to resource centre in the first instance. They have a list of “pre-approved” commonly prescribed medications which they can immediately okay.

If your medication is not on that list, occupational health will then become involved and will usually want to ensure you’re monitored for a period to ensure that no negative side affects have arisen in your case (as you rightly say different medications affect people differently). They will also likely want reports from your GP or whichever specialist is treating you.

There are some medications that are completely forbidden, but many will be in the grey area, where they can’t be approved immediately, but occupational health will sign you off to drive on them once you’ve been monitored to ensure that any negative side effects haven’t occurred in your case.

It sounds like that was @Gemz91’s experience, taking a commonly prescribed anti depressant, as helpfully outlined above.

43066 · 6 Jan 2020

notadriver said:
The side effects sound shocking to me

https://www.drugs.com/citalopram.html

As I understand it most drugs come with a scary sounding list of possible side effects, some of which occur more often than others, some of which may be very rare (albeit serious when they do occur). This is why a period of monitoring is usually required.

From a google search, Sertraline has a similarly scary sounding list of potential side effects to Citalopram, but Sertraline has been approved for train driving after a period of monitoring, as referenced above.

ComUtoR · 6 Jan 2020

43066 said:
but Sertraline has been approved for train driving after a period of monitoring, as referenced above.

It isn't automatically approved. Just that Gemz91 was prescribed it and was monitored for a number of weeks and because no side affects were found, was allowed to drive.

The way that anti-depressants work is why the process Gemz91 went through. I do not specifically want to speak for Gemz as their post was spot on but the reasons why you are prescribed are just as important, if not more so.

Occupational Health are there to help people on various medications to keep them on track as best possible, to monitor and maintain the health of the employee, to protect against litigation and various legal responsibilities the TOCs have, and to ensure that the staff member and those they have responsibility for are safe.

It isn't just 'black and white'

43066 · 6 Jan 2020

ComUtoR said:
It isn't automatically approved. Just that Gemz91 was prescribed it and was monitored for a number of weeks and because no side affects were found, was allowed to drive.

Yes you’re quite right. In fact, I had already edited my post along those lines to make that point clearer (great minds)!

Just because it was acceptable in @Gemz91’s case doesn’t mean it would be ok for anyone else, unless they had also been monitored and signed off.

It depends on the individual’s personal response, in every case.

whoosh · 7 Jan 2020

You need to declare any medication you take.

I do know a Train Driver who is taking prescribed Citalopram and in his case Occupational Health are aware of this, and he has been declared as fit to drive.

As others have said, different people react to medication in different ways.
Occupational Health are there to assess how any conditions or treatments might affect you, and put in place any restrictions or monitoring periods.

M84 · 7 Jan 2020

You guys are extremely well informed. You don't often come across forums where people take so much time to chip in in posts.

Petersmith36 · 7 Jan 2020

would being on morphine cause an issue for being a Conductor

221129 · 7 Jan 2020

Petersmith36 said:
would being on morphine cause an issue for being a Conductor

I would have thought so..

LCC106 · 7 Jan 2020

JAMES BENGE said:
No, I only take citalopram. I do not get any side effects at all. I've had many a medical review at work and passed them all.

Citalopram will not automatically exclude you. If you have been on it for some time and are on an even keel so to speak you should be fine. Definitely declare it. The railway Doctor will probably ask you a few questions about it and you can always ask them to put your mind at rest about it. Of course, I’m guessing your username is your real name so others will be able to see that you are on it.

Joliver · 7 Jan 2020

Just declare everything. Even down to paracetamol when you have a medical. As mentioned, you'll fail a medical if anything has shown that isn't declared.

M84 · 9 Jan 2020

Exactly this. I know of a P-Way worker who has used diazepam for 20+ years. Declared it at the medical, I think they asked the GP if he had any issues using it but he's allowed to use it at work as long as dose doesn't change etc.

whoosh said:
You need to declare any medication you take.

I do know a Train Driver who is taking prescribed Citalopram and in his case Occupational Health are aware of this, and he has been declared as fit to drive.

As others have said, different people react to medication in different ways.
Occupational Health are there to assess how any conditions or treatments might affect you, and put in place any restrictions or monitoring periods.

Louby · 9 Jan 2020

this is now the new HRT, ( useless if your a guy i know ) , just declare it , they won't have an issue, the issue is if you don't

tomnpt83 · 14 Aug 2020

Asking about the medication azathioprine and Mesalazine. Are these allowed?

CC 72100 · 14 Aug 2020

tomnpt83 said:
Asking about the medication azathioprine and Mesalazine. Are these allowed?

Without wishing to sound facetious, have you read the rest of the thread?

Unless it is especially common, there is no 'always approved' list. But by the same token, once occupational health get involved, probably no 'always forbidden' list either.

Only your Occupational Health department can say whether use is permitted, and if so with what restrictions (if any).

Because each individual is different, even if someone else has been on it with no issues doesn't necessarily mean it will be the same for you (and vice versa).

Citalopram and trainee driving positions

Member

RailUK Forums

Established Member

Established Member

Established Member

Member

Member

Member

Established Member

Established Member

Member

Established Member

Member

Established Member

Member

Established Member

Established Member

Established Member

Established Member

Established Member

Established Member

Established Member

Member

Member

Established Member

Established Member

Member

Member

Member

Member

Established Member