Some patients have historically requested the doctor to prescribe diazepam, or similar drugs like lorazepam, temazepam or clonazepam to help overcome fear of flying or to help them sleep during flights or for medical procedures that make them anxious (such as MRI scans).
For future reference, if you require such medications for a medical procedure (such as an MRI scan), we ask that in the first instance you try to contact the relevant healthcare professional who is carrying out the investigation to see if they can make the necessary arrangements to provide you with suitable medication or alternatively contact the referring clinician for advice. If you struggle to source the medication via the channels outlined above for the purpose of an investigation/procedure, you may submit a custom request to the practice which will then be reviewed by our GPs on a case-by-case basis to assess the suitability of that request.
However, after careful consideration, the practice has decided that we are NO longer able to accommodate such requests to prescribe benzodiazepines for fear of flying based on clinical safety, ethical prescribing standards, patient safety concerns and in accordance with national guidelines, as outlined below:
- Diazepam is a Class C/Schedule IV controlled drug in the UK.
- According to the prescribing guidelines that doctors follow (British National Formulary), diazepam is contraindicated (not recommended) for treating phobias (fears).
- Benzodiazepines are only licensed short term for a crisis in generalised anxiety. If this is the case, you should be getting support for your mental health. Fear of flying in isolation is not a generalised anxiety disorder.
- Although plane emergencies are rare, taking diazepam can reduce your awareness and slow down your reaction times, which may put you and others at risk during an emergency that requires decisive action, such as an evacuation.
- The use of sedative drugs like diazepam can cause sleep disorders and affect your activity levels. This could lead to you not moving around as much on your journey which may lead to an increased risk of developing a blood clot (Deep Vein Thrombosis – DVT) in the leg or even the lungs (Pulmonary Embolism – PE). Blood clots are very dangerous and can even prove fatal.
- NICE guidelines suggest that the use of benzodiazepines to treat short-term, ’mild’ anxiety is inappropriate.
- Whilst most people find diazepam sedating, a small number of people have been shown to demonstrate paradoxical agitation and aggression. They can also cause disinhibition and lead you to behave in a way that you would not normally do, which can pose a risk on the plane. This could impact on your safety as well as that of other passengers and could also get you into trouble with the law.
- 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 in this situation.
We recognise that fear of flying is a common issue, but there are alternative ways to help address this concern, such as cognitive behavioural therapy (CBT), mindfulness techniques or specialised flight anxiety programs. Please visit the link attached here for further information.
https://patient.info/news-and-features/how-to-manage-flight-anxiety
We would also suggest you talk to your local community pharmacist who may be able to recommend or suggest a suitable over the counter treatment (such as rescue remedy) to help manage your fears.
If you still wish to consider benzodiazepines as the medication treatment option for you to help alleviate fear of flying, we advise you to consult with a private doctor or travel clinic, who may be able to accommodate this request.
Thank you.
