This post explores FAA policy and ADHD, especially regarding medication. Originally published in 2012, it’s one of my most perennially popular posts. I try to keep it updated, so if you have new information, please share in a comment.
Now, it’s common lore that folks with ADHD gravitate to flying planes. Whether or not that is true, I do field many questions about ADHD-related restrictions on becoming a pilot.
One question came from the spouse of a commercial airline pilot. Her husband has been diagnosed with ADHD. From her report, symptoms manifested strongly at home. But, she claimed that FAA guidelines prohibit him from taking medication for it. Could this be true? Yes, it is true.
Another example: A young man I know diagnosed with ADHD at age 23, rails against this prohibition as absolutely unfair. Becoming a pilot is his lifelong dream. Seeing the disappointment on his face is heartbreaking.
Yet, I also saw how impaired he was before beginning stimulant medication:
- Repeatedly asked the same questions of the support group
- Always arrived very late to the meeting
- Reporting struggles with schoolwork and getting enough sleep.
With medication, he became sharper, more alert, and with much improved working memory. The difference truly was night and day. Did he realize how differently he appeared, compared to the somewhat stoned-looking presentation earlier?
If he stopped taking medication, would being in the cockpit somehow “stimulate” him into higher functioning? I’m unlikely to bet my life—or his—on it. The much-ballyhooed ADHD Hyperfocus? Not all it’s cracked up to be. Moreover, it’s certainly not reliable.
Let’s remember: ADHD is a highly variable syndrome. Moreover, it affects individuals. Many of whom also have ADHD-related sleep disorders that impair cognition all on their own. There are no cookie-cutter descriptions, answers, or strategies.
This young man was diagnosed as an adult, after a thorough and professional evaluation. What about potential pilots whose diagnosis as children was more informal? It might be worth re-visiting.
As best I can make out, this is the bottom line for potential pilots with ADHD:
- ADHD itself is not a disqualifying condition.
- Yet, if you have a formal diagnosis of ADD or ADHD, you may need to undergo additional testing in order to receive a medical certificate.
- Most medications used to treat ADHD are disqualifying (stimulants and Strattera).
- A 90-day period of taking no medication is required before evaluation.
- The FAA requires its own extensive evaluation for ADHD.
Current FAA Guidelines: Summary
Here is the December 2018 information from the FAA webpage concerning ADHD (Guide for Aviation Medical Examiners: Decision Considerations Disease Protocols – Attention-Deficit/Hyperactivity Disorder)
- The FAA requires an extensive evaluation if an applicant for medical certification has been diagnosed with or is currently taking one of the medications used to treat this condition.
- If medications are being taken, they must be discontinued for at least 90 days and you will be asked to undergo a neuropsychological evaluation with a clinical psychologist or neuropsychologist
- The testing is very familiar to the psychology world and consists of a battery of different tests that measure various areas of neurocognitive functioning. The evaluation is quite comprehensive and generally takes six or more exhausting hours to perform.
- The complement of tests provides an objective way for the clinical psychologist to test for ADHD and any other underlying pathology that affects one’s short and long-term memory, ability to multitask, and to understand and comply with instructions, and many other “executive” tasks. The psychologist can compare one’s scores to “normal” functioning individuals, rather than against the applicants’ own baseline scores since there is no baseline testing to compare to! This is one of the objections that opponents have for this type of evaluation process.
- Many young folks are placed on these medications without ever being tested. They are prescribed the meds based on parental or personal concerns about attentiveness to tasks such as job or school performance or other demonstrated history. In many cases, people who are treated for apparent symptoms don’t really have ADHD, but in order to rule it out, a formal clinical evaluation should be done.
FAA Medical Examinations:
From the FAA’s Guide for Aviation Medical Examiners (AME); Decision Considerations Disease Protocols – Attention-Deficit/Hyperactivity Disorder
Q: Why is a neuropsychological evaluation required?
Attention-Deficit/Hyperactivity Disorder (ADHD), formerly called Attention Deficit Disorder (ADD), and medications used for treatment may result in cognitive deficits that would make an airman unsafe to perform pilot duties.
Q: What testing is required?
There are two test batteries:
INITIAL BATTERY – performed on everyone; and
SUPPLEMENTAL BATTERY – performed when the Initial Battery indicates a potential problem.
Q: Why is a CogScreen-Aeromedical Edition (CogScreen-AE) required?
CogScreen-AE is a neurocognitive test developed to assist the FAA in the evaluation of the domains of neurocognitive performance most important for safety of flight.
Q: Who may perform a neuropsychological evaluation?
Neuropsychological evaluations should be conducted by a qualified neuropsychologist with additional training in aviation-specific topics. The following link contains a list of neuropsychologists who meet all FAA quality criteria. See FAA Neuropsychologist List (PDF).
If you have any experience or accurate on this topic, please share. Are there any workarounds to this prohibition?