Pilot Mental Health and Medical Certification

Pilot Mental Health and Medical Certification

Author: Jackson Barnett, Principal Attorney

In May 2024, the Federal Aviation Administration (FAA) introduced substantial revisions to its guidelines governing the evaluation of pilot mental health status. These updates grant Aviation Medical Examiners (AMEs) increased authority in assessing pilots reporting conditions such as anxiety, depression, and related mental health issues. If criteria are met, the AME can issue the pilot a medical certificate at the visit.

New Pilot Mental Health Rules for AMEs 

  1. Increased Autonomy for AMEs: AMEs now have greater discretion to determine the flight fitness of pilots with a history of uncomplicated anxiety, depression, and related conditions. This allows AMEs to issue medical certificates without FAA review under specific circumstances.  
  2. Criteria for Medical Certification: Pilots may qualify for certification if they meet criteria such as:
    • Two years without using mental health medications.
    • Satisfactory responses to a detailed questionnaire addressing mental health topics.
    • No additional concerns raised by the AME during evaluation.
  3. Questionnaire and Decision Tool: AMEs use a comprehensive questionnaire to assess pilots, covering sensitive topics like suicidal thoughts and hospitalizations, crucial for evaluating flight safety.
  4. Certification Process: AMEs can issue medical certificates if questionnaire responses show no concerns and no additional issues are identified. Affirmative responses or concerns lead to certification deferral pending further review. 
  5. FAA Oversight and Safety: While AMEs handle initial assessments, the FAA oversees safety violations and ensures compliance with aviation regulations, balancing pilot health and industry safety. 

Call Barnett Law Offices for a confidential attorney consultation on your situation to see if you may qualify for this new criteria. 

Antidepressant Medications for Pilot

Conditionally Acceptable:     
  Selective serotonin reuptake inhibitors (SSRI):  

  

  • Citalopram (Celexa)  
  • Escitalopram (Lexapro)  
  • Fluoxetine (Prozac; Sarafem)  
  • Sertraline (Zoloft)  
   Serotonin and norepinephrine reuptake inhibitors (SNRI):  

  

  • Desvenlafaxine (Pristiq)  
  • Duloxetine (Cymbalta)  
  • Venlafaxine (Effexor)  
   Dopamine/norepinephrine-reuptake inhibitor (NDRI):  
  • Bupropion (Wellbutrin) SR/ER formulations ONLY
Unacceptable:       
   Selective Serotonin Reuptake Inhibitor (SSRI):  
  • Fluvoxamine (Luvox)  
  • Paroxetine (Paxil)  
   Serotonin and norepinephrine reuptake inhibitors (SNRI):  
  • Levomilnacipran (Fetzima)  
   Dopamine/Norepinephrine-Reuptake Inhibitor (NDRI):  
  • Bupropion (Wellbutrin) IR formulations  
   Others:  
  • Vilazodone (Viibryd)  
  • Vortioxetine (Trintellix)  
  • Esketamine (Spravato)  
  • Tricyclic antidepressants (TCAs)  
  • Monoamine oxidase inhibitors (MAO-I)   

See the list of medications here. Read our blog with common FAQs on this topic here.

To discuss your situation and the new guidelines in a confidential setting, please contact our office for a consultation with an aviation attorney; contact Barnett Law Offices today.