Special Issuance Certification for Depression with Antidepressant Usage

For situational depression, Adjustment Disorder, or MINOR Depression, Aviation Medical Examiners (AME) may issue at the time of the medical exam for single episodes of symptoms that have completely resolved. If your medical application was deferred by the aviation medical examiner and is still under review, a FAST TRACK pathway is available for your AME to update the FAA via the AMCS on your current status. 

Health care providers including therapists and Licensed Clinical Social Workers provide “talk therapy,” or psychotherapy that is often helpful for short term bouts of depression or anxiety that doesn’t rise to the level of requiring medication.  A detailed clinical assessment from the provider can allow the AME to issue the medical at the time of examination.

The first step if you are on an antidepressant is refer to the Airman Information that explains the process.  Your AME can refer to the Decision Tool to determine eligibility for office issuance.

The FAA considers individuals for special issuance medical certification who are being treated for depression/anxiety and other related behavioral health diagnoses with one of the following antidepressant medications:

SSRIs (Selective Serotonin Reuptake Inhibitor):
Fluoxetine (Prozac; Sarafem)

Sertraline (Zoloft)

Citalopram (Celexa)

Escitalopram (Lexapro)

Serotonin Reuptake Inhibitor/5 HT1A Receptor Partial Agonist
Vilazodone (Viibryd)

NDRI (Norepinephrine Dopamine Reuptake Inhibitor)

Wellbutrin (bupropion) SR/ER only

SNRI (Serotonin/norepinephrine Reuptake Inhibitor)

Pristiq (desvenlafaxine), Cymbalta (duloxetine), Effexor (venlafaxine)

These 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, these medications may be used to treat conditions other than depression and will be considered with other medical histories on a case-by-case basis.

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