Every FAA-Approved Antidepressant for Pilots: The Complete 2026 List

If you're a pilot taking an antidepressant, one short FAA document matters more than any other: a one-page table titled Antidepressant Medications. Its current version, updated August 27, 2025, lists nine medications the FAA will consider for a Special Issuance, as long as you take only one of them. If a medication isn't in that column, the FAA's own guidance says it is not acceptable for Special Issuance. This post goes through every medication on the list: its brand name, its drug class, when the FAA added it, and the formulation limits that catch pilots off guard. It also covers what is still not allowed.

This is a medication reference. For a full walkthrough of the certification process, from choosing a HIMS AME to follow-up reports, read our guide to the FAA's Antidepressant Protocol and the antidepressants and flying condition guide.

The short answer: nine medications, one at a time

The FAA's table lists these as conditionally acceptable antidepressant medications with a Special Issuance, "used as a single agent, if otherwise qualified":

• Four SSRIs: citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac, Sarafem), and sertraline (Zoloft)
• Three SNRIs: desvenlafaxine (Pristiq), duloxetine (Cymbalta), and venlafaxine (Effexor)
• One NDRI: bupropion (Wellbutrin), SR/ER formulations only
• One SSRI/5-HT1A receptor partial agonist: vilazodone (Viibryd)

Three words in that table do a lot of work. Conditionally means being on the list doesn't guarantee approval. SI means Special Issuance: according to the FAA's AME Guide page on antidepressant use, the Authorization decision is made case by case, and your AME may not issue a certificate on their own. Single agent means exactly one antidepressant, never a combination.

The list is also only the first requirement. The FAA also looks at your diagnosis, how long you've been stable, and your history. Those are covered below.

How the list grew: 2010 to 2025

Before 2010, taking an antidepressant effectively ended your flying while you were on it. The list has grown in four steps since then, and the stability period has shortened along the way.

• April 5, 2010: The FAA published a policy statement in the Federal Register, effective the same day, allowing Special Issuance for pilots treated for depression with one of four SSRIs: fluoxetine (Prozac), sertraline (Zoloft), citalopram (Celexa), or escitalopram (Lexapro). That original policy required 12 months on a stable dose.
• May 31, 2023: The FAA added bupropion (Wellbutrin), a dopamine/norepinephrine-reuptake inhibitor, according to the AME Guide.
• April 24, 2024: The FAA added a second class of antidepressants, the SNRIs desvenlafaxine, duloxetine, and venlafaxine. With this expansion, the SSRI Protocol was renamed the Antidepressant Protocol.
• 2025: Vilazodone (Viibryd) moved onto the acceptable list. The FAA's table dated April 24, 2024 listed vilazodone as unacceptable, and the version updated August 27, 2025 lists it as conditionally acceptable.
• December 3, 2025: The AME Guide was updated to shorten the minimum stability period from 6 continuous months to 3.

A note on names: many FAA forms and checklists still say SSRI. The AME Guide states that every reference to SSRIs, the SSRI Protocol, or the SSRI program in its checklists, worksheets, and protocol pages is considered part of the Antidepressant Protocol and covers all of the conditionally acceptable medications. So if your SNRI or bupropion paperwork says SSRI, that's expected.

The FAA documents we reviewed don't give a separate announcement or effective date for vilazodone. The table's August 27, 2025 update date is the most reliable date available. If you're reading older articles or forum posts that call vilazodone unacceptable, they were probably written before that update.

Every acceptable medication, one by one

All nine share the same core requirements: a Special Issuance decided by the FAA, a single-agent regimen, at least 3 continuous months of documented stability, and evaluation by a HIMS AME. The details below cover what's specific to each drug.

Sertraline (Zoloft)

Sertraline is an SSRI and one of the original four medications named in the FAA's April 2010 policy. The FAA table lists it simply as sertraline (Zoloft), with no formulation restriction. If your pharmacy fills a generic, it's the same medication for FAA purposes. What matters is that the name and dose in your records match what your HIMS AME and psychiatrist report. See the sertraline medication page for a summary.

Fluoxetine (Prozac, Sarafem)

Fluoxetine is an SSRI and another of the original 2010 medications. The FAA table lists two brand names, Prozac and Sarafem, so either brand is covered. The FAA will consider fluoxetine even when it treats something other than depression: the AME Guide includes "any non-depression related condition" among the qualifying diagnoses. Keep in mind that the FAA's pharmaceutical guidance on antidepressants says underlying conditions require a current evaluation, so whatever condition you're treating is reviewed too. More on the fluoxetine page.

Citalopram (Celexa)

Citalopram is an SSRI from the original 2010 list, with no formulation restriction in the FAA table. The FAA's initial certification aid asks each of your providers when your medication last changed, including a dose change or a switch to a different medication. That question is worth keeping in mind if you move between citalopram and a related drug. The stability clock runs on the same medication at a stable dose, so a switch is a change your reports will have to explain. See the citalopram page.

Escitalopram (Lexapro)

Escitalopram is the fourth of the original 2010 SSRIs. The FAA table lists it as escitalopram (Lexapro), with no formulation restriction. The same single-agent rule applies here as to every other drug on the list: escitalopram can't be combined with another antidepressant, and prior use of other psychiatric drugs alongside an antidepressant is one of the FAA's rule-outs. See the escitalopram page.

Desvenlafaxine (Pristiq)

Desvenlafaxine is an SNRI, added in the April 24, 2024 expansion. The FAA table lists no formulation restriction. Being an SNRI isn't enough on its own, though: levomilnacipran (Fetzima), also an SNRI, remains on the FAA's unacceptable list. Always check the specific drug, not just its class. See the desvenlafaxine page.

Duloxetine (Cymbalta)

Duloxetine is an SNRI, also added on April 24, 2024. Doctors often prescribe it for conditions other than depression, such as chronic pain. The FAA's qualifying diagnoses include a non-depression condition treated with an acceptable medication, so that use can be considered. The underlying condition gets its own evaluation, however, and it may bring its own certification requirements. The FAA table lists no formulation restriction for duloxetine. See the duloxetine page.

Venlafaxine (Effexor)

Venlafaxine is the third SNRI from the April 24, 2024 expansion. The FAA table lists it as venlafaxine (Effexor). Unlike bupropion, it has no immediate-release versus extended-release distinction in the table. As with every medication on this list, your HIMS AME will verify the exact product and dose you take, so bring your prescription details. See the venlafaxine page.

Bupropion (Wellbutrin): SR and ER only

Bupropion is a dopamine/norepinephrine-reuptake inhibitor (NDRI), added on May 31, 2023. It is the only medication on the list where formulation decides everything. The FAA table says "SR/ER formulations ONLY" in the acceptable column and lists immediate-release (IR) bupropion as unacceptable. Sustained-release and extended-release products can be considered. Immediate-release cannot. Check your prescription label or ask your pharmacist exactly which formulation you take before you talk to a HIMS AME.

Bupropion also shows up in two other FAA tables, with different rules. When it's taken as Zyban for smoking cessation, the FAA's Smoking Cessation Medications table (updated April 29, 2026) lists bupropion SR as unacceptable. During a first treatment course, the AME may not issue while you're in active treatment, and you need a 7-day no-fly period after your last dose. For recurrent treatment or therapy lasting more than 6 months, that table refers AMEs to the FAA's Anxiety, Depression and Related Conditions table. The combination of bupropion and naltrexone (Contrave), used for weight loss, is on the FAA's Do Not Issue list. See the bupropion page for all three situations.

Vilazodone (Viibryd)

Vilazodone is classified in the FAA table as a selective serotonin reuptake inhibitor/5-HT1A receptor partial agonist. It is the newest addition: the April 2024 table listed it as unacceptable, and the table updated August 27, 2025 lists it as conditionally acceptable. The FAA table lists no formulation restriction. Vortioxetine (Trintellix), the other drug the FAA placed in that class, is still unacceptable. If you're weighing medications with your psychiatrist, don't assume the two are interchangeable for FAA purposes. See the vilazodone page.

The list at a glance

Every medication in this table requires a Special Issuance and must be your only antidepressant.

The stability requirement: 3 continuous months

According to the AME Guide, you can be considered only if, for at least 3 continuous months before you apply, you have been clinically stable and on a stable dose, without aeromedically significant side effects or an increase in symptoms. If you've been on the medication for less than 3 months, your AME must tell you that 3 months of continuous use is required before a Special Issuance. The FAA's Airman Information sheet adds that your stability must be documented, and that once you've been stable on the same dose for 3 months, you should meet with your HIMS AME to decide whether to submit.

This is the shortest the requirement has ever been. The 2010 policy statement required 12 months. Before the AME Guide was updated on December 3, 2025, it required 6 continuous months. The requirement is now 3.

Stability is only one of the criteria. The AME Guide also requires one of these diagnoses:

• Major depressive disorder (mild to moderate), single or recurrent episode
• Dysthymic disorder
• Adjustment disorder with depressed mood
• Any non-depression condition for which the medication is used

You also must not have symptoms or a history of psychosis, suicidal ideation, electroconvulsive therapy, treatment with more than one antidepressant at the same time, or multi-agent drug protocol use, which the FAA defines as prior use of other psychiatric drugs together with an antidepressant.

What is not acceptable

The FAA table lists these as unacceptable, "used as a single agent or in any combination product":

• SSRIs: fluvoxamine (Luvox) and paroxetine (Paxil)
• SNRI: levomilnacipran (Fetzima)
• NDRI: bupropion (Wellbutrin) immediate-release formulations
• SSRI/5-HT1A receptor partial agonist: vortioxetine (Trintellix)
• Esketamine (Spravato)
• All tricyclic antidepressants (TCAs), including amitriptyline, nortriptyline, and doxepin
• All monoamine oxidase inhibitors (MAOIs)

The unacceptable column isn't the whole story. The AME Guide says that if you take an antidepressant that isn't listed in the table, your AME must tell you it isn't acceptable for Special Issuance. That covers drugs like trazodone and mirtazapine, which appear in neither column. The FAA's Do Not Issue table (updated June 28, 2023) also lists psychiatric medications, including antidepressants, "even when used for conditions other than mental health." A low dose of trazodone for sleep or a tricyclic for migraine prevention is still a psychiatric medication to the FAA.

Benzodiazepines follow separate rules. The FAA's Do Not Fly table lists anti-anxiety medications, including alprazolam (Xanax) and lorazepam (Ativan). It warns that these can impair performance even when you feel alert, and it tells AMEs to defer if you use them routinely. The Do Not Issue table covers controlled substances, including any open prescription for chronic use with no resolution. If you take a benzodiazepine alongside an antidepressant, remember that the Antidepressant Protocol rules out prior use of other psychiatric drugs together with an antidepressant.

If your medication isn't on the list

Don't stop, switch, or taper a medication on your own to get certified. Changing antidepressants is a clinical decision for you and your prescriber. A HIMS AME can explain what a change would mean for certification. If you and your doctor do decide to switch to a medication on the list, expect to need 3 continuous months of documented stability on the new medication and dose before your HIMS AME submits.

If you stop antidepressant treatment entirely, the AME Guide says your AME must note it and defer. To reapply for regular issuance, you must be off the medication for at least 60 days and have a favorable report from your treating physician showing stable mood and no aeromedically significant side effects. In every case, the FAA's Airman Information sheet is direct: do not fly under 14 CFR 61.53 until you have an Authorization from the FAA.

The process in brief

Our Antidepressant Protocol guide covers each step in detail. Here is the outline, based on the FAA's initial certification aid and recertification materials:

• Initial certification: a face-to-face, in-person evaluation and report from a HIMS AME, a report from a board-certified psychiatrist, and a neuropsychologist evaluation that includes CogScreen-AE. If your prescriber isn't a board-certified psychiatrist, you'll also need a treating physician report.
• All reports must be current, which the FAA defines as within the last 90 days.
• Your HIMS AME completes a new exam, submits it as deferred, and sends the complete package to the FAA within 14 days. Partial or incomplete packages are not reviewed.
• After approval, you'll need a face-to-face HIMS AME evaluation and a treating psychiatrist report every 6 months, for all classes.
• Since December 15, 2022, the neuropsychologist evaluation and routine CogScreen-AE are no longer required for renewal, unless they're clinically indicated or specified in your Authorization letter. This change does not affect initial evaluations.
• You and your providers must tell the FAA right away about any change in your condition, any change in dose or medication, or any plan to reduce or stop your medication.

Check your own medication

The FAA's list is short, but the details matter: formulation, what you take it for, and whether anything else is in your regimen. Use the ClearedMed medication checker to look up any medication and see its FAA status, with links to the official source. When you're ready to apply, the MedXPress prep tool helps you list every medication and diagnosis accurately, and the AME directory can help you find an examiner.

If you're dealing with depression, get treatment. The FAA's list has grown from four medications to nine, and the stability period has dropped from 12 months to 3. Your health comes first, and a documented, well-managed treatment plan is what the FAA's pathway is built around.

Sources

• FAA Antidepressant Medications table, updated August 27, 2025
• FAA AME Guide: Use of Antidepressant Medications, last updated December 3, 2025
• FAA AME Guide: Pharmaceuticals, Antidepressants, last updated April 24, 2024
• FAA Airman Information: SSRI Initial Certification, updated August 26, 2026
• FAA Certification Aid: SSRI Initial Certification/Clearance, updated August 26, 2026
• FAA SSRI Recertification: Neuropsychological Report Changes and FAQs, updated December 28, 2022
• FAA Do Not Issue and Do Not Fly medication tables, updated June 28, 2023
• FAA Smoking Cessation Medications table, updated April 29, 2026
• Federal Register policy statement: Special Issuance of Airman Medical Certificates to Applicants Being Treated With Certain Antidepressant Medications, April 5, 2010