In the Cockpit, on Antidepressants: A Doctor Weighs In

Prozac, Zoloft, Celexa and Lexapro are some of the most popular antidepressants on the market. On Friday, the Federal Aviation Administration approved these medications for pilots suffering from depression — reversing a longtime ban on any antidepressant use by the men and women who fly commercial planes.

Under the new policy, pilots who take one of those four prescription antidepressants will be allowed to fly if they have been successfully taking the medication for a year without side effects that could pose a safety hazard in the cockpit.

Dr. Dale Archer, a board-certified psychiatrist and distinguished fellow of the American Psychiatric Association, strongly agrees with the new policy — particularly the mandate that they stay out of the cockpit for a year while they adjust to the medication.

"It’s very important that we understand these medications affect brain chemistry in many ways," Archer told "Side effects can include insomnia, anxiousness, feeling fuzzy, foggy, tired, and irritable.

"It’s hugely inappropriate for a newly diagnosed pilot fresh on antidepressants to be in the cockpit. There is a transition period with these medications and someone in that window should not be flying."

Another concern is what effect altitude may have on someone who takes these medications.

"To my knowledge, there have been no studies done on the effects of antidepressants and altitude," Archer said. "But it is hugely important to find out if there are side effects. We should also find out what are the effects on fine motor skills and reaction time. These are all important questions that should be assessed."

Even though this new policy raises some red flags, the FAA and Archer are in agreement that this is an important step in the field of mental health.

"We need to change the culture and remove the stigma associated with depression," FAA Administrator Randy Babbitt told reporters Friday. "Pilots should be able to get the medical treatment they need so they can safely perform their duties."

"On one hand, we want to de-stigmatize metal illness as much as possible," Archer added. "On the other hand, we also need to closely monitor the situation. Twenty years ago, no one understood that many cases of mental illness were indeed caused by chemical imbalances and could be treated with medication. Now everyone knows that, but people think it’s no big deal to pop a Prozac, and that’s not the case."

Archer said it’s imperative for the FAA to treat each pilot on a case-by-case basis.

"Some patients feel better after two days, some feel better after two months," he said. "You can’t predict who is going to need what. It’s just careful monitoring during that beginning period by a doctor to make sure the patient is responding with no side effects that are problematic."

Several labor unions representing aircraft owners, pilots and crews had urged the government to lift the ban. The Army, the Civil Aviation Authority of Australia and Transport Canada already allow some pilots to fly who are using antidepressant medications.

The Associated Press contributed to this report.