Agency’s New Protocol Reduces Medication Stabilization Time from 6 to 3 Months

The Federal Aviation Administration has taken an unusually cooperative step towards pilot mental health reform, reducing the stabilization wait time for approved antidepressant medications from 6 months to just 3. Though this is, in itself, a basic change, it reflects years of industry efforts that seem to finally be getting the attention they deserve.

Under the revised policy, airmen and air traffic control specialists may now submit Special Issuance medical packages after maintaining a stable dose of an approved antidepressant for at least three continuous months. The update comes more than a year after the FAA’s Mental Health and Aviation Medical Clearances Aviation Rulemaking Committee issued a report recommending 24 separate reforms -- this addresses just one of them.

The FAA expanded and renamed its antidepressant protocol in 2023 and again last April. Together, the revisions added four new classes of drugs to the pool of conditionally acceptable antidepressants for Special Issuance authorizations, bringing the total to nine.

Several widely requested alterations remain in limbo. Pilots who discontinue medication must still wait a minimum of 60 days before reapplying for regular medical certification, plus documentation from a treating physician. Applicants continuing treatment must undergo evaluation by a HIMS-qualified aviation medical examiner, and factors like psychosis, suicidal ideation, electroconvulsive therapy, multi-agent psychiatric drug regimens, or concurrent SSRI use remain disqualifying.

The policy adjustment follows sustained pressure from pilot-advocacy groups and several high-visibility incidents that revived advocacy for updated aeromedical mental-health rules. Organizations argue that making pilots too scared to look for therapy or medication leaves them flying with unresolved mental health issues… a pattern they warn greatly increases risk.

With how deep the overarching issue runs, groups like the Pilot Mental Health Campaign are not backing down anytime soon. Their legislation, known as the Mental Health in Aviation Act of 2025, would require the FAA to review and update medical regulations across the board.

“Legislation like the Mental Health in Aviation Act is still imperative to hold the FAA accountable for the changes they clearly acknowledge need to be made,” read a statement from the Pilot Mental Health Campaign. “We cannot wait years and years for reforms to be cherry-picked while larger systemic issues are swept under the rug.”

FMI: www.pmhc.org