[aviation news]
The FAA’s decision to deny a special medical clearance for an airline pilot taking antidepressant medication was “arbitrary and capricious,” a federal appeals court has ruled.
In a decision handed down on June 27, the U.S. Court of Appeals for the District of Columbia Circuit said it could not reverse the FAA’s decision, but it did order the agency to explain its reasoning. The ruling could provide a path forward for pilot Michael Solondz, who has been denied an FAA special issuance four times over the past four years while taking the antidepressant drug mirtazapine, known by the brand name Remeron.
“Determinations regarding which medications categorically pose unacceptable risks and which pilots are medically fit to fly lie squarely within the sound discretion of the Federal Aviation Administration,” wrote Judge Cornelia Pillard. “But the agency must reasonably explain its actions. It has not done so here. The agency has failed to explain why it categorically disallows medical certification to all pilots who take the medication that Solondz was prescribed and finds beneficial, rather than permitting conditional approvals if merited under the agency’s robust medical clearance process. We accordingly remand to the Federal Aviation Administration to explain its decision.”
Under the FAA’s current protocols, pilots taking antidepressant medication cannot qualify for an unrestricted medical certificate and must seek a special issuance from the agency. The special issuance process is limited to pilots taking a medication on the FAA’s “conditionally approved” list, which includes drugs like fluoxetine (Prozac), sertraline (Zoloft), and bupropion (Wellbutrin), but not Remeron.
A pilot seeking a special issuance must also be stabilized on their medication for six months and submit to an assessment by an aviation medical examiner (AME). Applicants with a history of suicidal ideation, psychosis, treatment with multiple concurrent antidepressants, or electroconvulsive therapy cannot qualify.
‘Gaps’ in Reasoning
Solondz worked as a commercial airline pilot and held an unrestricted first-class medical certificate for nearly two decades before personal tragedies, including the death of his father and father-in-law, caused him to develop anxiety. After being diagnosed, he took an extended medical leave from his job and was prescribed Lexapro, which is on the FAA’s conditionally approved list, to treat his symptoms.
But Lexapro came with unpleasant side effects, including dizziness and lightheadedness, and his physician switched him to Remeron. Solondz found the new medication effective and easy to tolerate, and by taking his prescription at night, he avoided the daytime sedation and fatigue that can be side effects of Remeron.
Solondz eventually felt ready to return to work and applied for a special issuance, which was denied in September 2021. He faced further denials in July 2022, April 2023, and April 2024, then petitioned for a review of the agency’s decision.
The appeals court found that the FAA relied on a single argument—that Remeron generally tends to increase somnolence in users—without considering how the medication affected Solondz as an individual. The agency already anticipated the possibility of side effects by requiring pilots taking antidepressants to undergo six months of treatment and an assessment by an aviation medical examiner, the court said, and there is no clear reason why that system wouldn’t work for a pilot taking Remeron.
“We do not—and cannot—substitute our judgment about the content of these studies for the FAA’s own,” the decision read. “But it is our duty to identify material gaps in the agency’s articulated rationale. The mirtazapine studies suffice to support a requirement that pilots in Solondz’s situation submit to the controls inherent in a special issuance. The six-month waiting period and case-by-case scrutiny of airmen’s neuropsychological condition that are built into the special issuance process afford the FAA the opportunity to determine in each individual case whether, for example, nocturnally administered mirtazapine caused sedative effects after the acute treatment phase.”
But the FAA seems to be arguing that the “risk of somnolence from mirtazapine is so severe, persistent, or unpredictable that the guardrails within the special issuance process, as called for by the antidepressant protocol, are insufficient to protect aviation safety,” the decision continued. “If that is the case, the FAA must articulate and support its reasoning. We cannot fill in the blanks by supplying a reasoned basis for the FAA’s policy that the agency itself has not given.”
The FAA’s approved medications list has been a source of contention for years, with regulators working to strike a delicate balance that allows pilots to seek mental health treatment while excluding those who could be dangerously unstable. Some antidepressant medications, including fluvoxamine (Luvox) and paroxetine (Paxil), remain off-limits due to their potential side effects.
“This decision just confirms what I’ve known all along: that my choice to self-ground and address my health concerns, ensuring I wouldn’t jeopardize the flying public, was the right decision at the time,” Solondz said in a statement released by his attorneys. “I sincerely hope the FAA will take the court’s guidance to heart, do their part, and issue my certificate without further delay.”
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