Questions and Answers
FAA Policy on Antidepressants

April 2, 2010

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Why does this policy only deal with four types of antidepressant medications?
The medical community has data that shows that these medications can be safely used to treat mild-to-moderate depression.

Isn't it still possible that, if a pilot is on another antidepressant medication not listed here, they are still going to be forced to hide their condition or just not seek treatment out of fear of losing their pilot's certificate?
Other medications will be considered in the future as we gain experience and data under our new policy. Pilots are legally obligated to be truthful regarding their health during their FAA physical examination. The responsibility to be truthful belongs to the pilot.

What action does the FAA take when pilots either disclose they are being treated for depression or request treatment?
A pilot will be grounded until all symptoms of the psychiatric condition being treated are improved by the single medication and the pilot is stable for 12 months. The FAA requires:

1. A consultation status report (and follow-up reports as required) from a treating psychiatrist attesting to and describing the pilot's diagnosis, length and course of treatment, dosage of the antidepressant medication taken, and any side effects from the antidepressant the applicant takes or has taken in the past.
2. A written statement prepared by the pilot describing his or her history of antidepressant use and mental health status.
3. A report of the results of neurocognitive psychological tests.
4. An evaluation and written report from a Human Intervention and Motivation Study (HIMS)-trained Aviation Medical Examiner (AME) who has reviewed the above items and recommends a special-issuance medical certificate.

How long will a pilot be grounded?
For pilots who are beginning treatment with antidepressants, they will be unable to fly for one year. For those pilots who either take advantage of the six-month reporting period or have stopped flying and have a medical history of successful treatment, those pilots should be able to fly within a few months.

How many extra exams will a pilot have to go through if he chooses to disclose that he takes antidepressants?
The pilot will be on a special issuance (waiver) as long as he or she is on medication. The pilot will need to be seen at least annually by a HIMS AME, more if the AME determines that additional visits are warranted. The pilot will need to see a psychiatrist every six months.

What does the FAA do if a pilot discloses that he or she is consulting a therapist (e.g., for anxiety) but there is no clinical diagnosis of depression?
A pilot will not be allowed to fly while undergoing treatment. Once the treatment is complete, the pilot may return to flying.

How do you know that an airline will not take adverse action against a pilot who takes antidepressants?
If a pilot receives a special issuance medical certificate from the FAA, then we expect the airline to treat that pilot as they would with any other medical waiver case.

Is a pilot required to report psychotherapy received under an Employee Assistance Program?
Yes.

What kind of safeguards does the FAA have in place now to ensure that pilots who are dealing with mental illness get help? Do you rely on annual exams or a co-worker pointing it out?
Pilots have a regulatory duty and professional responsibility to not fly if they know (or should know) that they have a physical or mental condition that may make them unsafe to fly. We depend on the honesty of pilots, their family, friends and co-workers, to get pilots the help they need. The regular FAA physical examination is a critical mechanism for ensuring that a pilot is healthy, and for identifying pilots with potentially disqualifying medical conditions.

How many pilots do you estimate suffer from depression?
Generally, 10% of the population is thought to have some type of depressive symptoms. Not all depressions are the same, and not all require treatment with medications. Pilots are a subset of the general population.

How many pilots have lost their certificates for coming forward and saying they're depressed or because it was discovered they were lying about their condition?
Within the past six years, the Office of Aerospace Medicine has not referred any cases for revocation of a medical certificate based solely the fact that a pilot intentionally withheld information about a diagnosis of depression.

Why does the FAA consider depression a safety hazard?
Depression can lead to distraction and make it difficult for a pilot to focus.

Then shouldn't the traveling public feel unsafe if their pilot is on anti-depressants?
The public should feel safe with this program. It was designed to allow only well-treated and stable pilots to fly. The pilots will be well monitored, with multiple layers of safeguards.