HIMS-SSRI/Anti-depressants

The second most common issue leading to a HIMS evaluation is a pilot who takes, or who has taken, an antidepressant medication.

In 2010, the FAA published a pathway to consider Special Issuance Authorization medical certificates for a pilot who takes an antidepressant.

If you are an airman who uses a Selective Serotonin Reuptake Inhibitor (SSRI) medication such as:

  • Celexa (Citalopram Hydrobromide)

  • Lexapro (Escitalopram Oxalate)

  • Prozac (Fluoxetine Hydrochloride)

  • Zoloft (Sertraline Hydrochloride)

The FAA requires additional testing, medical monitoring, and documentation for your FAA medical certification and recertification. 

The FAA utilizes the Human Intervention and Motivation Study (HIMS) program for oversight of the process and requires airmen to be seen by a HIMS AME for their certification. 

SSRI Decision Path - II1024_1.jpg

The applicant must have one of the following diagnoses:

  • Major depressive disorder (mild to moderate) either single episode or recurrent episode

  • Dysthymic disorder

  • Adjustment disorder with depressed mood

  • Any non-depression related condition for which the SSRI is used (anxiety, PTSD, etc.)

For a minimum of 6 continuous months prior, the applicant must have been clinically stable, as well as on a stable dose of medication (no changes), without any aeromedically significant side effects and/or increase in symptoms.

If the applicant has been on the medication for less than 6 months, the HIMS Examiner must advise that 6 months of continuous use is required before consideration for a Special Issuance.

The applicant DOES NOT have symptoms or any history of:

  • Psychosis

  • Suicidal ideation

  • Electroconvulsive therapy (ECT), Transcranial Magnetic Stimulation (TMS)

  • Treatment with multiple SSRIs concurrently

  • Multi-agent drug protocol use (prior use of other psychiatric drugs in conjunction with SSRIs)

If you are on a SSRI that is not listed above, the HIMS Examiner must advise that the medication is NOT acceptable for consideration for a Special Issuance.

If you stop an antidepressant and need to restart it, the minimum waiting period is 6 months on a stable dose and with minimal or no symptoms.

If you are currently taking an SSRI but your prognosis predicts that you would do okay without it, you are able to apply for a medical certificate after 60 days without the SSRI.

Complex Medical Problems

The third reason that pilots may find the HIMS program is secondary to complex medical problems (transplants, stroke, etc.).