FAA Under Fire for Blanket Ban on Antidepressant Remeron in Pilot Medical Certification

For over a decade, the FAA has permitted pilots with mild to moderate depression to fly while using a limited list of approved antidepressants, specifically fluoxetine (Prozac), sertraline (Zoloft), citalopram (Celexa), and escitalopram (Lexapro). However, the agency’s categorical rejection of other medications is now facing legal scrutiny. 

On 27 June 2025, the US Court of Appeals for the D.C. Circuit challenged the FAA’s longstanding refusal to consider mirtazapine (Remeron) for special issuance medical certificates, citing a lack of transparency and fairness in the agency’s process. 

The case involved Michael Solondz, a veteran airline pilot diagnosed with anxiety. Initially prescribed Lexapro, Solondz switched to Remeron after experiencing negative side effects. Remeron proved effective, and he sought FAA clearance to return to flying. However, the FAA categorically denies pilots medical certification if they use Remeron, citing FDA data showing a high risk of drowsiness. 

Solondz submitted multiple applications for a Special Issuance First-Class Medical Certificate between 2021 and 2023, accompanied by professional evaluations demonstrating clinical stability and the absence of adverse side effects. Each request was denied, with the FAA’s core justification being his use of Remeron. 

The court found the FAA’s reasoning insufficient. Although drowsiness is a known side effect of Remeron, the FAA failed to explain why it does not assess individual cases, especially since its own antidepressant protocol requires a six-month observation period to evaluate side effects and clinical stability. 

The court concluded that the FAA’s blanket policy was “arbitrary and capricious”. However, it did not order the agency to approve Solondz’s medical certificate. Instead, the FAA must now provide a clearer rationale or reconsider its one-size-fits-all approach. 

This ruling sets a significant legal precedent. It highlights the need for more nuanced, evidence-based evaluations of pilots’ mental health treatments, balancing safety with fairness. While Solondz continues to wait for a resolution after four years, his persistence has opened the door for future pilots seeking medical clearance under non-standard treatments.