Applying for a FAA medical certificate while taking SSRI medication does not does not automatically mean you will never get to fly again. Airmen with a history of Selective Serotonin Reuptake Inhibitor (SSRI) usage may still be eligible to hold a medical certificate, despite their history with SSRI medications, through the special issuance process. While SSRI medication disqualifies an individual from an aeromedical eligibility standpoint, if you can establish stability while on the SSRI medication, with no cognitive deficits caused by the SSRI use, then the FAA will consider you for a special issuance authorization – meaning you still get to go fly!
Often times, an individual may be prescribed SSRI medication by his/her treating physicians to combat depression, feelings of sadness, or other external factors affecting that person. SSRI medications are commonly known as antidepressants and generally work by increasing levels of serotonin (the “feel good hormone”) within the brain. Consequently, airmen with a history depression, anxiety, or some other mood disorder may be prescribed SSRI medications such as Citalopram (Celexa), Escitalopram (Lexapro), Fluoxetine (Prozac), or Sertraline (Zoloft).
If an airman elects to discontinue use of SSRI medication, his/her Aviation Medical Examiner (AME) may note that fact and defer issuance of the medical certificate, until such time as the airman’s treating physician can opine that the airman is of a stable mood. Typically, the FAA wants to see at least a 60-day period of no SSRI medication usage when an airman elects to discontinue SSRI medication. There are a few ways to document this weaning properly and in a way that will give the FAA more confidence in the airman’s prognosis. It is important that when you attempt to wean off SSRI medication that you do so under the careful watch of a medical physician’s supervision. If, however, the airman elects to continue using SSRI medication, the analysis becomes more involved, as you will see below.
In order to properly assess an airman’s aeromedical eligibility due to continued SSRI medication usage, he/she will likely need to see a Human Intervention Motivational Study (HIMS) AME for proper assessment of his/her aeromedical fitness. To learn more about the role and purpose of a HIMS AME, you may consider reading the following blog: Selecting a HIMS AME. As such, the HIMS AME will need to inquire into several areas of the airman’s medical history to determine whether he/she is eligible for a medical.
If the airman is taking Prozac, Lexapro, Zoloft, or Celexa, then the HIMS AME may be able to recommend medical certification to the FAA. If any one of these SSRI medications are being used by the airman, then the HIMS AME will likely inquire as to the length of time that the airman has been on that prescribed medication. If the period of prescription is less than six (6) months, the HIMS AME will likely require thee airman to remain on a stable dosage of that SSRI medication for at least six (6) months before consideration of a FAA medical certificate.
If, however, the airman has been on one of the above-mentioned SSRI medications for at least six (6) months, the HIMS AME will then consider additional information, such as the nature of the underlying diagnosis and the treatment. If the underlying diagnosis and treatment suggests that the airman has a history of, or is currently using, multiple psychiatric medications and/or has a history of unacceptable diagnosis or symptoms, the HIMS AME will likely defer the medical application to the FAA. This, of course, is a less than desirable outcome and should be discussed with the FAA medical attorneys at The Ison Law Firm for further guidance and representation.
Should the HIMS AME find that there is an acceptable diagnosis and treatment relating to the airman’s need for SSRI medication, then the HIMS AME will require the airman to provide a typed statement, describing his/her mental health history, antidepressant use, and any other treatment related to the SSRI medication usage. This written statement must be signed and dated. Additionally, the airman will be required to provide copies of all medical/treatment records related to his/her mental health history. Typically, the FAA will require treatment records for past related symptoms where the airman was not on SSRI as well as from the date that the airman began treatment to the present.
Additionally, the FAA will likely require a written report from the airman’s treating physician, as well as a psychiatric evaluation from a board-certified or HIMS-trained psychiatrist, along with CogScreen results and a neurocognitive evaluation from a HIMS-trained neuropsychologist. This information is time sensitive and must be current within the last 90 days for FAA purposes. Once this information is gathered and given to the HIMS AME, the HIMS AME will send all document for initial review to the FAA for a decision on the airman’s medical certification.
Given the delicate nature of SSRI medication usage in relation to FAA medical certification, having an experienced attorney representing your interests throughout the medical certification process is essential. Often times, we are able to use our contacts within the aviation industry to help expedite what would otherwise be a lengthy, confusing, and costly process.
Applying for a FAA Medical Certificate While taking SSRI Medication? If you are planning to apply for medical certification with the FAA and have a history of SSRI medication usage, call the pilot lawyers at The Ison Law Firm today – 1-855-FAA-1215. Aviation law is all we do and nothing else!