Special Issuance Certification for Depression with Antidepressant Usage

Effective April 5, 2010, the FAA began considering individuals for special issuance medical certification who are being treated for depression with one of four specific antidepressant medications.  All classes of medical certification will be considered, but individuals who are granted a special-issuance medical certificate under this policy may take only one type of antidepressant medication limited to the following four medications: Fluoxetine (Prozac), Sertraline (Zoloft), Citalopram (Celexa), or Escitalopram (Lexapro). All these medications are SSRIs, (Selective Serotonin Reuptake Inhibitor) antidepressants that help restore the balance of serotonin, a naturally occurring chemical substance found in the brain.

These four specific medications may be used safely in appropriate cases with proper oversight, and produce fewer side effects than previous generations of antidepressants.  While the focus of this policy statement is on individuals being treated for depression, the FAA realizes that these four medications may be used to treat conditions other than depression.  The FAA will consider applicants with other medical histories and make determinations on a case-by-case basis under the special-issuance process just as it always has.

In addition to treating psychiatrists, AMEs who have specialized training under a program called the Human Intervention and Motivation Study (HIMS) also will assist the FAA by making recommendations about certification cases to be considered under this new policy.  The HIMS program is a safety-critical aviation program established in the early 1970’s.  The program, developed specifically for commercial pilots, was designed as an alcohol and drug assistance program to coordinate the identification, assessment, treatment, and medical certification of pilots in need of help.  Under HIMS, pilots who successfully meet rigorous FAA protocols may be returned to duty in accordance with 14 CFR 67.401 (Special Issuance).  The FAA will apply the basic HIMS evaluation and monitoring approach to the policy and HIMS AMEs will participate in a specialized training program tailored to evaluating and monitoring applicants who wish to be considered under this new policy.

The FAA’s certification policy for SSRI’s continues to evolve in an attempt to streamline the process and minimize the burden to applicants while maintaining the high level of aviation safety.