Mental health is no longer a taboo topic in aviation. More pilots than ever are getting the assistance they require — and that includes taking SSRIs (Selective Serotonin Reuptake Inhibitors) such as Zoloft, Lexapro, or Celexa.
So how does SSRI use impact your ability to fly? Can you still pass your FAA medical? The answer is yes, but you have to go through a process known as FAA Special Issuance.
Here, we have an easy to follow step by step on how pilots can go through this process and get back to flying safely, legally, and with peace of mind.
A Pilot’s Guide to FAA Special Issuance
An FAA Special Issuance is a case-by-case medical approval granted to pilots with disqualifying medical conditions, such as mental illness diagnoses using SSRIs.
If you’re already on an SSRI, you won’t obtain a standard medical certificate, but you may qualify further through the FAA Medical Special Issuance Florida program under specific criteria.
Which SSRIs Are FAA-Approved?
The FAA currently allows four SSRIs under the Special Issuance process:
- Fluoxetine (Prozac)
- Sertraline (Zoloft)
- Citalopram (Celexa)
- Escitalopram (Lexapro)
The FAA does not currently accept any other antidepressants for use by pilots.
What makes a pilot qualified for SSRI Special Issuance?
In order to be eligible, a pilot must qualify the following requirements:
- Diagnosed with a mild to moderate depression
- Taking only one of the FAA approved SSRIs
- Stable on the same dose for a minimum of 6 months
- No history of major psychiatric issues (e.g. suicide attempt, bipolar, psychosis)
Cleared by both a psychiatrist and a HIMS Aviation Medical Examiner Florida
The Process: Step-by-Step Guide to FAA SSRI Special Issuance
- Consult a HIMS-Certified FAA Medical Examiner
Before doing anything else, book an appointment with a HIMS FAA Medical Examiner Florida.
This is a specially trained doctor authorized by the FAA to handle psychiatric and substance-related medical cases.
Your examiner will:
- Review your history
- Explain the documentation you’ll need
- Guide you through the FAA’s expectations
Remember: Not all AMEs are HIMS certified, so make sure to verify credentials.
- Get a Psychiatric Evaluation
The FAA requires a full evaluation from a board-certified psychiatrist.
This report must include:
- Diagnosis confirmation
- Treatment history
- Risk assessment (suicidal thoughts, psychosis, etc.)
- Confirmation of stability on medication
The psychiatrist must explicitly state you are safe to operate an aircraft.
- Undergo Neurocognitive Testing
This step ensures your medication hasn’t affected your cognitive ability.
A neuropsychologist will run tests covering:
- Memory
- Attention span
- Reaction time
- Problem-solving
These tests help reassure the FAA that you can safely perform complex pilot tasks.
- Submit Your Package to the FAA
Once all the reports are ready (from your psychiatrist, HIMS AME, and neuropsychologist), your HIMS FAA Medical Examiner Florida will compile and submit everything to the FAA.
The package includes:
- Psychiatric evaluation
- Neurocognitive test results
- AME’s recommendation
- Details of your SSRI use
The FAA will then review your case and — if approved — issue a Special Issuance Medical Certificate.
- Maintain Compliance With Monitoring
Once approved, you’ll be issued a medical certificate valid for 6 to 12 months, depending on the case.
- Ongoing requirements may include:
- Regular check-ins with your HIMS AME
- Follow-up psychiatric reports
- Continued medication stability
If you stay compliant, renewals become easier over time.
Why Pilots in Florida Should Act Now
Florida boasts one of the highest pilot populations in the country, with numerous general aviation and commercial pilots. As mental health becomes increasingly addressed, more pilots are obtaining Special Issuance approvals than ever.
Being under the care of a local expert is important.
A Florida certified HIMS Aviation Medical Examiner can streamline the process, prevent delays, and provide you with the optimal opportunity to return to flying again.
Flying With an SSRI Is Possible, If You Follow the Process
Taking care of your mental health doesn’t mean giving up your flying privileges. The FAA’s Special Issuance procedure has permitted FAA pilots to legally return to flying while using SSRIs, although the path requires working with the proper professionals and following FAA protocols.
Whether you are a leisure flyer, or commercially involved in aviation, don’t delay. Talk to a certified HIMS examiner, gather the right documentation, and start your path back to the skies.
If you’re in Florida, book your appointment with a HIMS FAA Medical Examiner Florida at Aviation Medicine, led by Dr. Weinberg, a trusted expert with decades of FAA medical experience.
Reach out to us today at aweinberg@medavex.org or call (727) 648-2402 to begin your FAA Special Issuance process and return to the cockpit feeling confident!