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PHD. MBA. MHS. Type rated on A350, A330, B777, B747-400, B747-200, B757, B767, B737, B727. International Airline Pilot / Author / Speaker. Dedicated to giving the gift of wings to anyone following their dreams. Supporting Aviation Safety through training, writing, and inspiration. Fighting for Aviation Safety and Airline Employee Advocacy. Safety Culture and SMS change agent.

Wednesday, October 19, 2011

Pilots on Prozac?

Wednesday Wellness with Dr. Larry
"Off the Record Q & A with a Local A.M.E."

DR. Larry

"Dr. Larry, I heard that the FAA is going to start allowing pilots to fly with Prozac. I always said, “I’d rather have a pilot on Prozac, than one that needs Prozac.” Can you give us the scoop on this and what Prozac does to the body? How do you feel about pilots flying with it? Is this safe?"

In a long-time coming policy reversal, the FAA last year changed the protocol for pilots taking one of four antidepressants or wishing to. These four are from a class of medications called SSRI (selective serotonin reuptake inhibitor). Prior to the FAA's decision, ANY antidepressant was disqualifying. Now a pilot has the potential to be certified taking Prozac (fluoxetine), Celexa (citalopram), Zoloft (sertraline) or Lexapro (escitalopram).

This was a landmark decision the FAA wrestled with for many years and in part was held up due to legal questions. As noted and like the rest of the general population, many pilots deal with anxiety and depression issues. However, they were restricted from taking medications which could help them feel substantially better. The FAA also knew there were many pilots taking these medications yet not reporting it for fear of losing their license. The trick was in figuring out a way for these wayward reporters to come clean without reprisal and be allowed to continue flying.

Certification is on a case-by-case basis when a pilot is taking one of the four specific antidepressants. If one wishes to pursue this sort of therapy, a number of hoops need to be jumped through. Click HERE to view the FAA’s protocol for certification with SSRIs.

SSRIs were deemed ok to fly with because they are generally well tolerated and have a very low potential for side effects, especially sedation. Word is circulating there will likely be a few more options in the next couple of years as well.

Depression and anxiety as well as obsessive-compulsive disease and premenstrual mood disorder are due to a depletion of neurotransmitters in the brain. SSRIs and other antidepressant type medications typically work by increasing or replenishing specific neurotransmitters, so instead of people believing it’s mind over matter, it’s more often matter over mind.

I personally have thought for a long time we needed medication options, besides cognitive mental health work, for treating depression and/or anxiety in the pilot populations. Now we have a means which allows pilots to continue their occupation or joyful hobby. We've come a long way yet we have a long way to go.

To your good health,

Dr. Larry

To Read Dr. Larry's bio, click HERE.

Thank you Dr. Larry. This is great information during a high time of stress for pilots.


  1. Sounds like a good thing. Nobody wants depressed pilots!

    1. The job can do that all by itself. ;) Fatigue. Away from home. Yeah... we need to have a source if we need it. Thanks for the comment.

  2. I agree, I'd rather have a pilot on Prozac than one who needs to be on it and isn't!

  3. As a retired practitioner, I have to agree with the opening statement about prefering a pilot on an SSRI, rather than a pilot who needs one! This is a small, cautious step but an important one. The FAA's medical folks are cautious and extremely slow. I suspect that a significant number of pilots (and their airlines and the flying public) will benefit from this rule change. Thanks for an excellent post. -C.

    1. Thanks C. Sorry it took me so long to reply. I hadn't realized I missed this. I too would rather have them on them, than needing them. Thanks for the comment.

  4. Pilots should be able to fly while taking SSRIs IF...they are evaluated more frequently by FAA Medical Examiners. Side effects of SSRIs vary with individuals and the course of treatment. Employers of pilots have every right to know this information and to see a certified medical examiner clear the pilot on a more frequent basis that a biennial or annual medical. One cautionary tale is that of Sgt Tingwall, a New Mexico State Police Helicopter Pilot who crashed killing himself and a rescued passenger. He was taking fluoxetine for 7 years and never reported it as he was legally required to do so. Perhaps, if a qualified medical examiner had followed him closely, he and the passenger would be alive today.

    1. That's very sad about Sgt Tingwall. Was the accident attributed to the drugs? It's a shame he thought he had to hide them. Now that we can take them, more people will be monitored. That's a good thing. Thanks for your comment.

    2. No, the NTSB determined, " is unlikely that the pilot’s use of fluoxetine to treat depression played any role in this accident. The investigation found no evidence that the pilot had any preexisting medical or toxicological condition that adversely affected his performance during the accident flight." [NTSB/AAR-11/04 PB2011-910404]

    3. Thank you for the added information!


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