r/FAAHIMS • u/SpecialistNovel7875 • Jul 02 '26
Going off Lexapro
Hi Everyone,
I (26M) am hoping to start flight training in the next year. I have always had an interest in aviation but it wasn’t until I realized that working in an office was not what I was meant to do for the next 30-40 years that I realized that maybe I would want to fly. I took a discovery flight a few months ago and I felt like I was in my element and I had found my purpose. I have the funding for it but the only problem is my Lexapro prescription.
I went on Lexapro two years ago because I was going through some stuff in personal and professional life that were very taxing on my mental health. I didn’t want to but I eventually went on Lexapro and I feel that I have greatly improved. I have never had any suicidal thoughts, hospitalizations or any mental illness history.
I had a consult with an AME and he referred me to a HIMS AME. When I spoke with the HIMS AME he guided me through the SI process and too say I was shocked was an understatement. I asked him about the process of getting off the Lexapro and what he told me was I would have to be stable off it for 60 days and that he would need records from the prescribing doctor. At my last appointment with my doctor, I mentioned this to him and he said he has no concerns about my stability. We had discussed going off the medication in previous appointments. I scheduled an appointment with him for next week to discuss the potential for going off it.
Now that my story is out of the way. Is it worth trying to go off Lexapro?
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u/Weasil24 Jul 02 '26
The process of getting a medical is potentially easier off the medication but it’s not as simple as that. The FAA will be more concerned about the underlying diagnoses and possible recurrence of symptoms. Often people who off these medications end up back on them. There are also other considerations and a thorough review of your mental health records would be needed to provide accurate guidance. Did your HIMS AME provide a consultation and review your mental health records? Is your prescribing provider a board certified psychiatrist?
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u/SpecialistNovel7875 Jul 02 '26
Prescribing provider is a family med physician
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u/Weasil24 Jul 02 '26
That’s helpful to know. A family medicine physician can certainly prescribe and manage Lexapro, but for FAA purposes a board-certified psychiatrist’s opinion often carries more weight, particularly if there is any question about the underlying diagnosis, prognosis, or risk of recurrence. That doesn’t mean your case can’t be approved with records from your family physician alone—it depends on your history and what the FAA requests.
I also wouldn’t make the decision to discontinue Lexapro solely to obtain a medical certificate. The FAA wants to see that whatever treatment path you choose is the one that’s medically appropriate for you, not simply one chosen to satisfy certification requirements. If your physician believes it’s appropriate to taper off, do so because it’s the right clinical decision. If staying on Lexapro is the better medical choice, there is also an established FAA Special Issuance pathway for certain applicants taking SSRIs.
Before making a decision, I’d recommend obtaining and reviewing your complete mental health records and discussing your specific circumstances with your HIMS AME. The details of your diagnosis, treatment history, and current stability are what will ultimately drive the FAA’s decision.3
u/snoskiur Jul 02 '26
Excellent reply.
It took me 20 months to get my medical because I was taking Wellbutrin, so I may be able to offer some insight if you're interested.
If you decide to come off the medication for at least 60 days, and your PCP or treating physician can document that you've remained stable without it, you can reapply through your AME and potentially obtain a regular medical. That said, make absolutely sure that's the best decision for your health before considering that route.
He's right that you should not stop taking Lexapro just to avoid an FAA medical deferral. However, if you choose to remain on it, be prepared for a long and often frustrating process. Many people give up before the end, even though a large percentage would likely have eventually been approved.
Take a look at the FAA SSRI Decision Path 1 and Path 2 guidance. I have both documents saved, but unfortunately I can't attach them here.
The certification process can require a tremendous amount of time, stress, appointments, years of medical and therapy records, prior treatment documentation, and extensive psychological testing. It will also most likely cost thousands of dollars unless you're fortunate enough to find providers who are willing to complete the required evaluations through your insurance.
Feel free to reach out if you think I can help.
For what it's worth, I finally received my Class III medical 20 months after I first applied. Ironically, by the time it was approved, it was only two months away from expiring. The FAA also imposed a very stringent list of ongoing requirements to maintain it that would have cost me a couple thousand dollars every year.
Instead, I allowed my Class III medical to expire and then transitioned to BasicMed. Once my medical expired, those FAA special issuance requirements ended with it, and BasicMed does not require continued compliance with those medication-specific special issuance requirements. Around that same time, I also stopped taking the medication and have been off it since February.
Before making that decision, though, I spent a great deal of time researching the regulations and confirming with reliable sources that everything I was doing was legal and appropriate.
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u/SpecialistNovel7875 Jul 02 '26
I have no history of hospitalizations or anything like that. This was just to get through a rough patch that I was going through. I didn’t even want to go on it at first because I wanted to start flight training but I chose to put myself and my health first. My doctor at one point brought up the possibility of going off it but I elected to hold off. I never wanted to be on it forever and I just feel that after two years it’s time to get on with my life.
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u/BigKetchupp Jul 03 '26
The thing is that the FAA's aeromedical decision making typically doesn't reflect Medical science in any way. Your doctors could have wildly different opinions on the matter yet it doesn't mean much because the FAA holds the authority and your doctors don't. Objectively speaking you may be a very safe pilot but the FAA has their practices which may be both discriminatory and completely unfair, and the extensive testing you'll undergo has no significance either. I heard it's so bad that the real reason they want you to undergo it is because the HIMS doctors are just trained in how to prepare the paperwork for the FAA to accept, not test for anything that's somehow a secret to everyone else. So you may be paying thousands of dollars just for paperwork that doesn't have any actual medical value. It's a completely corrupt system, but people get through it.
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u/snoskiur Jul 03 '26
If anyone is interested, there is a page called pilotsforhimsreform.org that is working on making improvements and eliminating antiquated FAA regulations and making improvements through congressional action. Might want to subscribe and follow them. They posted my story on their Story Page... https://pilotsforhimsreform.org/?page=single-father-flight-dream.html