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SSRI & Cognitive-Enhancement Medication
Answered By AOPA

The 2021 Guide for Aviation Medical Examiners states that, “An individual may be considered for an FAA authorization of a Special Issuance (SI) or Special Consideration (SC) of a Medical Certificate (Authorization) if…”, in addition to other things, "…the applicant DOES NOT have symptoms or history of: 

  • Psychosis
  • Suicidal ideation
  • Electro convulsive therapy
  • Treatment with multiple SSRIs concurrently
  • Multi-agent drug protocol use (prior use of other psychiatric drugs in conjunction with SSRIs.)


If an individual has a history of using an SSRI and a cognitive-enhancement medication (ADHD med) at the exact same time, is that a complete and total disqualifier for a FAA medical certificate? If so, why?

2 Replies
AOPA Staff Answer

Hi Nathaniel,

The answer to this question is not a simple yes or no. The FAA is concerned with those conditions that were severe enough to require treatment and if the said condition has resolved and will likely require a HIMS evaluation before deciding if a pilot is eligible to hold a medical certificate. Be prepared, this process is both costly and lengthy. 

AOPA is happy to discuss this further with you over the phone. Any one of our Medical Certification Specialists are available to speak with you Monday-Friday 8:30am- 6:00pm EST We can be reached at  1-800-872-2672 #3 

Ron Levy and/or Dr Chien will likely reply to your question as well. They both have a vast amount of knowledge on this subject.

1217 Posts

Since she invited my attention…

When you don't qualify for the standard SSRI protocols (which you don't), the process gets a whole lot more lengthy, difficult, complicated, and expensive – and your medical insurance will NOT cover it. What you do NOT want to do is even start an FAA medical application until you are sure it will be successful.  That means working with an expert on this particular process like Dr. Chien, who helped the FAA write the policy. He will probably pop in here, or you can reach him via his web site