FAA Updates Mental Health Certification Guidance

FAA Updates Mental Health Certification Guidance

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Jackson Barnett

Principal Attorney

In May 2024, the Federal Aviation Administration (FAA) introduced substantial revisions to its guidelines governing the evaluation of pilots’ 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. 

Key Changes and Updates 

  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. 

Commonly Accepted and Unacceptable 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  
   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  
  • 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.

If you need legal assistance or have questions about aviation law, contact Barnett Law Offices today.