Can I Get a Medical If I Use Antidepressant Medication?
Yes. You can absolutely hold a medical certificate while using an antidepressant medication, but it will require special issuance. Further, you will need to follow the FAA’s specific Antidepressant Protocol to ensure your treatment regimen is acceptable.
FAA Antidepressant Protocol
Mental health conditions such as anxiety and depression are often disqualifying for airman medical certification under 14 C.F.R. §§ 67.107(c), 67.207(c), and 67.307(c). Even so, the FAA has implemented a standard protocol when determining whether an airman may be granted an Authorization of Special Issuance under 14 C.F.R. § 67.401, which authorizes the airman’s AME to issue them an FAA airman medical certificate under specific terms despite the disqualifying condition. Accordingly, if you are being treated with an FAA-accepted regimen, there is a good chance you’ll be able to get a medical in your pocket.
The FAA’s Antidepressant Protocol can seem daunting at first glance. There are several hoops that airmen must jump through to demonstrate their aeromedical fitness to the FAA, and navigating those hoops can be both expensive and time-consuming. But if you are willing to jump through the necessary hoops, then it is quite likely you will eventually be found eligible to hold an FAA airman medical certificate.
The first hoop requires airmen to establish an FAA-accepted treatment regimen. In the case of antidepressant use, this requires airmen to see their treating physician, therapist, counselor, and/or psychiatrist to get healthy. If the provider and the airman decide to begin treatment with an antidepressant medication, then they must select one of the FAA’s “conditionally acceptable” antidepressant medications, which include common medications like Lexapro, Zoloft, Cymbalta, and certain formulations of Wellbutrin, among several other options. It is also important to note that the FAA will only consider airmen using a conditionally acceptable antidepressant medication as a single agent. So, airmen seeking FAA airman medical certification under the Antidepressant Protocol must establish effective treatment through the use of a single conditionally acceptable antidepressant medication, which means maintaining a stable mood with no symptoms or side effects while on the same dose of medication.
The second hoop requires airmen to document their mental health history and effective treatment. Once the airman has established effective treatment and continued mood stability while on a stable dosage of medication for at least three months, then the airman should gather all records related to evaluation, diagnosis, and treatment of any mental health conditions.
Once you’ve established a stable treatment regimen and gathered the necessary documentation, you can begin seeing doctors for current evaluations. You’ll start by seeing your treating physician (the person prescribing the antidepressant medication). They will verify that the airman has been on a stable dosage for at least three months and that the regimen is effective with no adverse side effects. Next, the airman must see a board-certified psychiatrist, who will complete an evaluation and report in accordance with FAA specifications. Note, if you’re prescribing/treating physician is a board-certified psychiatrist, then they will only need to complete the documentation required for the psychiatrist. Finally, airmen pursuing special issuance under the Antidepressant Protocol must see a neuropsychologist and complete a CogScreen-AE and neurocognitive evaluation. If each of those reports are favorable, then the airman can put the final touches on their application for an airman medical certificate.
For airmen employed in aviation, specifically commercial pilots seeking a first- or second-class airman medical certificate or ATCS, a chief pilot or Air Traffic Manager report is required.
Once all the listed documentation and evaluation reports have been collected, the airman must see their HIMS AME to formally apply for an airman medical certificate. The HIMS AME will confirm that all the necessary information has been provided and then complete the required HIMS AME checklist and HIMS AME report. All the information is then submitted to the FAA’s Aerospace Medical Certification Division for review, and a decision is rendered regarding eligibility.
If the medication dosage changes during the application process or the airman decides to discontinue medication use altogether, then they will have to self-ground and provide further documentation for FAA review, often requiring them to restart at step one of the Antidepressant Protocol.
Recent Updates
In December 2025, the FAA made a noteworthy change to the AME Guide and its Antidepressant Protocol. For many years, since at least 2018, the Antidepressant Protocol required a six-month waiting period to demonstrate stability on a stable dosage of medication. In December 2025, the FAA reduced that waiting period to just three months. Accordingly, an airman who started taking a conditionally acceptable antidepressant medication in December 2025, when the change was made, and who has remained clinically stable on that same dosage, may now be eligible to apply for special issuance under the antidepressant protocol.
Navigating the Antidepressant Protocol
While the FAA’s Antidepressant Protocol can be reduced to a few seemingly simple steps, the process is riddled with potential pitfalls and hurdles on the way to certification. To ensure that the process goes as smoothly as possible, it is usually a good idea to reach out to your HIMS AME or an aviation attorney with experience in medical certificate defense before beginning your journey to certification under the Antidepressant Protocol.
