SSRI Antidepressants & Flying

The FAA permits pilots to fly while taking one of four approved selective serotonin reuptake inhibitors (SSRIs): fluoxetine (Prozac), sertraline (Zoloft), citalopram (Celexa), and escitalopram (Lexapro). This policy, formalized in April 2010 after a decades-long blanket ban, opened a pathway for thousands of pilots managing depression or anxiety to maintain their medical certificates. However, the approval process is rigorous and involves multiple evaluations, a mandatory wait period, and ongoing monitoring.

To qualify, you must have been on one of the four approved SSRIs at a stable dose for at least six months with no adverse side effects. The FAA requires documentation from your prescribing physician confirming clinical stability, as well as a CogScreen-AE (Aeromedical Edition) neuropsychological test administered by an FAA-approved psychologist. This computerized test evaluates cognitive functions critical to flight, including attention, processing speed, and multitasking ability.

Once approved, pilots receive a Special Issuance authorization that must be renewed annually. Each renewal requires an updated status report from your treating physician and may require repeat CogScreen testing. Pilots who switch to a non-approved SSRI, add a second psychiatric medication, or experience a relapse of symptoms will typically have their authorization suspended until stability is re-established. The FAA is firm that only monotherapy with an approved SSRI is acceptable — combination psychiatric regimens are disqualifying.