FAA Medical Certification and Antidepressants
Can you get an FAA medical certificate while taking an antidepressant? The answer may be yes.
The FAA recognizes that pilots can experience depression, anxiety, and other mental health conditions. Over the years, the FAA has expanded its Antidepressant Protocol, allowing pilots taking certain antidepressant medications to be considered for First-, Second-, or Third-Class medical certification on a case-by-case basis.
Note that seeking a Third-Class medical certificate does not make the process any easier or shorter compared to seeking a First-Class medical certificate while undergoing the Antidepressant Protocol.
Treatment Comes First
If you are experiencing depression or anxiety, your first priority should be appropriate treatment—not your FAA medical certificate. Work with qualified mental health professionals to establish the correct diagnosis and treatment plan, which may include counseling, medication, and ongoing monitoring.
Once your symptoms are well controlled and you have been clinically stable on a stable dose of one FAA-conditionally acceptable antidepressant for at least three continuous months, you may be eligible to begin the FAA's initial antidepressant certification process.
The Initial FAA Certification Process
Pilots who wish to remain on an antidepressant generally need to work with a HIMS Aviation Medical Examiner (HIMS AME), like me. The HIMS AME helps coordinate the required evaluations, reviews the complete documentation, provides an aeromedical assessment and recommendation, and submits the package for FAA review. The final Special Issuance decision is made by the FAA.
The FAA has published a detailed Initial Certification Aid explaining exactly what it expects. Depending on the circumstances, the application includes the pilot's personal statement and treatment records as well as reports from the prescribing provider, a board-certified psychiatrist, a neuropsychologist performing the required neurocognitive evaluation, and the HIMS AME. The FAA currently requires these evaluation reports to be current, generally within 90 days. One important role of the HIMS AME is to make referrals to the right evaluators.
As of summer 2026, the general cost for the psychiatrist evaluation may range from $2500-$4000, and the cost for the neuropsychological evaluatoin starts at $1500, to be paid directly to each evaluator.
A Longer Process—but a Path to Flying
Initial certification while taking an antidepressant is not a quick process. There are multiple evaluations, records to collect, and continuing monitoring requirements. A complete and carefully prepared application can help avoid additional delays caused by missing information.
Most importantly, pilots should know that receiving appropriate treatment for depression or anxiety does not necessarily end a flying career. For pilots who meet the FAA's requirements, the Antidepressant Protocol provides a pathway to obtain and maintain medical certification while continuing appropriate mental health treatment.
FAA requirements change periodically and every case is evaluated individually. Pilots considering certification under the Antidepressant Protocol should review the current FAA guidance and discuss their individual circumstances with a HIMS AME before beginning the certification process.
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