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As of April 2024, the FAA changed terminology, and going forward all references to SSRIs, SSRI Protocol, or SSRI program in existing checklists, worksheets, charts, or protocol pages in the AME Guide are considered encompassed in the Antidepressant Protocol and include all conditionally approved medications.
- Qualifying Conditions: Limited to mild-to-moderate major depressive disorder, dysthymic disorder, adjustment disorder with depressed mood, or non-depression uses for the medication.
- Disqualifying History: No history or symptoms of psychosis, suicidal ideation, electroconvulsive therapy, or concurrent multi-drug psychiatric treatment.
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Pilots and air traffic controllers taking specific approved antidepressants can obtain a medical certificate through an FAA Special Issuance authorization under the updated FAA framework known as the Antidepressant Protocol. This expanded allowed medications and shortened the stability timelines required vs the previous framework formerly known as the SSRI Protocol. You must be on a single, stable dose of an approved medication with no significant side effects for a minimum of 3 continuous months (reduced from the previous 6-month requirement). This must be a single approved drug (no multi-agent combinations allowed).
The FAA conditionally permits select medications within specific classes:
- SSRIs (Selective Serotonin Reuptake Inhibitors): Fluoxetine (Prozac), sertraline (Zoloft), citalopram (Celexa), and escitalopram (Lexapro).
- SNRIs (Serotonin-Norepinephrine Reuptake Inhibitors): Duloxetine (Cymbalta), venlafaxine (Effexor), and desvenlafaxine (Pristiq).
- NDRIs (Norepinephrine-Dopamine Reuptake Inhibitors): Bupropion (Wellbutrin).
- Others: Vilazodone.
FlightPhysical's Staff Take Home Message
Evaluation and Documentation Process
- Initial Deferral: Your Aviation Medical Examiner (AME) cannot issue the certificate on your first special issuance application; they must defer it to the FAA Aerospace Medical Certification Division.
- Cognitive Testing: You may be required to complete a CogScreen-AE computerized cognitive screening test administered by a qualified professional to ensure the medication does not impair your attention, memory, or processing speed.
- Clinical Status Report: You need a comprehensive status report from your treating physician detailing your diagnosis, stable dosing history, treatment response, and absence of side effects .
Created at
Dec 23, 2025 15:51:16
Updated at
Oct 1, 2026 22:12:30