We Will No Longer Prescribe Sedating Drugs for Fear of Flying
Fear of Flying Policy:
Due to a medical safety alert from Aviation trained doctors; we have taken the decision to no longer prescribe sedating drugs such as Diazepam, which is sometimes used to treat fear of flying, and medications such as Zopiclone, which is used as a sleeping tablet. There are several very good reasons why prescribing these drugs is not recommended:
1 – Diazepam and Zopiclone are both sedative, which means it makes you more relaxed and sleepier. If there is an emergency during the flight, it may impair your ability to concentrate, follow instructions and react to the situation. This could have serious safety consequences not just to yourself, but to those around you.
2 – Sedative drugs can make you fall into an unnatural non-REM sleep. This means you won’t move around as much as you would do in natural sleep. This can cause you to be at increased risk of developing a blood clot in the leg (DVT) or even the lung. Blood clots are very dangerous and can even prove fatal. This risk is even greater if your flight is greater than 4 hours.
3 – Whilst most people find Diazepam sedating, a small number have paradoxical agitation and increased aggression. It can also cause disinhibition, leading you to behave in a way that you would not normally. This could impact on your safety as well as that of other passengers. A similar effect can be seen with alcohol, which has led to passengers being removed from their flights. It could also get you into trouble with the law.
4 – The British National Formulary (BNF), the reference guide for prescription of medications by doctors in the UK, states that the use of benzodiazepines is not allowed in treating phobia. Your doctor would be taking a significant legal risk by prescribing against these guidelines. They are only licensed short term for a crisis in generalised anxiety. If this is the case, you should be getting proper care and support for your mental health, and not going on a flight.
5 – Diazepam and similar drugs are illegal in several countries. They may be confiscated, or you may find yourself in trouble with the police
Given the above, we will no longer be prescribing Diazepam for flight anxiety or Zopiclone for flight insomnia. We appreciate that fear of flying is very real and very frightening. A much better approach is to tackle this properly with a Fear of Flying course run by the airlines. We have provided a number of these below:
British Airways https://www.britishairways.com/en-gb/information/travel-assistance/flying-with-confidence
Virgin https://flyingwithoutfear.co.uk/
EasyJet https://fearlessflyer.easyjet.com
Further Information:
- Flight anxiety does not come under the remit of General Medical Services as defined in the GP contract and so we are not obliged to prescribe for this.
- Patients who still wish to take benzodiazepines for flight anxiety are advised to consult with a private GP or travel clinic.
- It is important to declare all medical conditions and medications you take to your travel insurer. If not, there is a risk of nullifying any insurance policy you may have.
Other Useful Links:
[i] British National Formulary; Diazepam – https://bnf.nice.org.uk/drug/diazepam.html
[ii] British National Formulary; Hypnotics and anxiolytics – https://bnf.nice.org.uk/treatment-summary/hypnotics-and-anxiolytics.html
[iii] Generalised anxiety disorder and panic disorder in adults: management. NICE Clinical guideline [CG113] Published date: January 2011 Last updated: July 2019 https://www.nice.org.uk/guidance/cg113
[iv] Acute and delayed effects of Alprazolam on flight phobics during exposure. Behav Res Ther. 1997 Sep;35(9):831-41
[v] Travel Health Pro; Medicines and Travel; Carrying medication abroad and advice regarding falsified medication – https://travelhealthpro.org.uk/factsheet/43/medicines-abroad
