Selective Serotonin Reuptake Inhibitors (SSRIs) are a type of antidepressant medications. Commonly prescribed for conditions such as anxiety and depression, SSRIs are a class of antidepressants which help to regulate serotonin (a neurotransmitter that affects mood regulation) levels in the brain.
Specific Guidelines for Pilots Who Take SSRIs
According to the Federal Aviation Administration (FAA), pilots and air traffic controllers may apply for a Special Issuance authorization to continue flying or working while taking certain SSRIs to treat their depression. What this means for pilots in 2025 is that, while taking SSRIs would have previously disqualified them for approved flight, the FAA now recognizes that when certain SSRIs are used under specific conditions, pilots and air traffic controllers can safely continue their aviation careers.
More specifically, under the Special Issuance program, the FAA currently approves the use of Fluoxetine (Prozac), Sertraline (Zoloft), Escitalopram (Lexapro) and Citalopram (Celexa).
However, the FAA makes decisions regarding Special Issuance Authorizations on a case-by-case basis, taking into account such factors as each pilot’s individual diagnosis, medication effectiveness and any potential side effects experienced by that pilot.
While SSRIs are generally considered safe, the FAA also recognizes the need for caution and the potential for adverse effects such as those which may be experienced with differing drug metabolism, serotonin syndrome, and for those taking multiple medications.
Also required by the FAA are a demonstration that the individual can safely perform their duties and a thorough, professional evaluation. Pilots taking SSRIs must demonstrate a stable condition while on a consistent dose of their medication for a time period of no less than six months. In addition, they are required to undergo the testing and evaluation of a physician.
To further aid in the monitoring and evaluation of pilots undergoing treatment for depression with SSRIs, the FAA also utilizes the Human Intervention Motivation Study (HIMS) program, which was originally created for pilots suffering from alcohol dependence.
The bottom line is that, with the adherence to flight safety protocols and with careful and thorough monitoring, the FAA now approves SSRIs as a valuable tool for treating certain psychiatric conditions in pilots.
Dr. Lisa Merilson, Psy.D. of Aviation Neuropsychology is committed to helping pilots navigate this FAA medical certification process adeptly and with confidence. Her goal is to make the process as smooth as possible, providing clear guidance and professionalism every step of the way.
A pilot herself, with over 100 accrued flight hours, she possesses a unique compassion for pilots. Dr. Lisa Merilson understands and appreciates the time and effort pilots invest in obtaining their flight credentials and she has dedicated her knowledge and experience to helping her clients successfully maintain them. An accomplished neuropsychologist and owner of Volusia Neuropsychology & Behavioral Health with over 21 years of clinical practice experience, Dr. Merlison is also HIMS certified.
The HIMS Neuropsychologist Advantage
HIMS neuropsychological evaluations are much more suited to aviators than ordinary neuropsychologists, because HIMS neuropsychologists are specifically trained for the cognitive testing of pilots and air traffic controller (ATCs). HMIS-trained neuropsychologists are also intimately familiar with industry standard testing including CogScreen-AE, as required by the FAA. Additionally, HIMS neuropsychologists possess the ability to compare test data and evaluation results specific to pilots and ATCs with those of the general population – an extremely valuable tool for assessing the cognitive competence of aviators.
Proper neurocognitive function is essential for effective pilot performance and the subsequent safety of the passengers and crew. Human Intervention Motivation Study (HIMS) neuropsychological evaluation is required by the Federal Aviation Administration (FAA) in cases where it has been determined critical to assess neurocognitive deficits in pilots. Not only will these neurological assessments help to assure that a pilot is operating at an acceptable level of cognitive function, but they are also required to determine the eligibility for medical certification, recertification and Special Issuance.
What Is Included in FAA-Required HIMS Neurological Testing for Pilots
Concentration, reaction time, situational awareness, impulse control, spatial recognition, reaction time, coordination, mental calculation, verbal comprehension, reasoning and memory are all included in the neurological testing of pilots required by the FAA.
The Aviation Neuropsychology evaluation process includes:
A comprehensive review of records
A face-to-face interview
Computer-based cognitive testing
Neuropsychological test administration and
An FAA-compliant evaluation report
Who Is FAA-Approved to Provide Neuropsychological Evaluations for Pilots
As stated by the FAA, neuropsychological evaluations for aviators must be conducted by a neuropsychologist on the FAA Neuropsychologist List. Dr. Lisa Merilson is conveniently located within the Volusia Neuropsychology & Behavioral Health offices at 512 Canal Street in the heart of New Smyrna Beach and can be reached for more information by calling 386-478-9873.
Volusia Neuropsychology & Behavioral Health strives to help patients manage life’s obstacles, meet and exceed their expectations and establish long-term, positive results. Providing services within a supportive environment, the team at Volusia Neuropsychology & Behavioral Health is dedicated to the evaluation of brain function, cognitive and emotional assessments.