As one AME put it, maybe the guy who flew into the building in Austin would not have if he had been treated with antidepressants.
In a long overdue decision, the FAA has approved the use of four anti-depressant medications (Prozac, Zoloft, Celexa, and Lexapro) for use by pilots with 1st, 2nd, and 3rd class medical certificates. This decision has been based on recommendations from various organizations from the Aerospace Medical Association to the AOPA to the U.S. Army as well as a progressive Federal Air Surgeon and his staff.
There are caveats. The pilot must be stable on the medication for 12 months and must have a letter from the treating psychiatrist attesting to the stability of the condition. Since most people on antidepressants are treated by primary care physicians (PCP), I am not sure whether the FAA will require pilots to see a psychiatrist as a consultant to affirm what the PCP has already stated.
In an interesting twist, the FAA is also offering amnesty to any pilot who is on antidepressants who reports the use within the next six months. However, those pilots will be grounded until they meet the requirements of the new order which I would estimate at four to 12 weeks. The pilots must have been stable on one of the approved medications for 12 months so I am not sure how many pilots will be forthcoming if they are on one of the nonapproved medications and face grounding for a year.
I think this is a good decision. Mild to moderate depression is basically a medical illness with psychological symptoms. Since the advent of selective seratonin re-uptake inhibitors (SSRIs), many with this problem have been treated so successfully that literally their lives were changed.
Pilots are no different. Of all the reasons I have had to deny a pilot medical over 25 plus years, the use of antidepressants has been the number one reason. The depression was well controlled and there were no side effects of the medications.
The use of antidepressants was not going to happen under the previous Federal Air Surgeon whose main psychiatric advisor was dead set against the use of the medications. mostly based on older medications which had lots of side effects and did not work very well. Fortunately, under FAS Dr. Fred Tilton, a much more enlightened approach to medical problems has emerged out of Washington with the support of Dr. Warren Silberman, Chief of Airmen Certification for the FAA's Aerospace Medical Certification Institute. I applaud the Dr. Tilton for his approval of this new policy. In the world of "take no risk" bureaucrats, Dr. Tilton is a star in the FAA.