Jesmond Health Partnership does not prescribe benzodiazepines for fear of flying

We are often asked to prescribe benzodiazepines (e.g diazepam, temazepam, lorazepam) for fear of flying.

We have agreed a practice policy that we will no longer prescribe these drugs for fear of flying.

There are several good reasons why prescribing benzodiazepines for this purpose is not deemed safe and is no longer recommended. We have taken the decision to put patients’ safety first and will no longer issue prescriptions for these reasons:

• Benzodiazepines such as Diazepam and other sedative drugs are no longer recommended for treatment of phobias because other treatments are safer and more effective.
• Benzodiazepines are sedating, which means they make you sleepy and slow reaction times. If there is an emergency during a flight, it may affect your ability to concentrate, follow instructions and react to the situation. This could have serious safety consequences for you and others.
• The sedative effects of these drugs can affect breathing and cause low oxygen levels, which could be life-threatening, especially with the lower circulating oxygen levels on an aeroplane in people with breathing problems or when combined with alcohol.
• Sedative drugs can make you fall asleep, but this is not natural sleep. This means you won’t move around as much as during natural sleep, and this can increase your risk of developing a blood clot (DVT) in your leg or lung. Blood clots are dangerous and can be fatal. This risk is greater if your flight is longer than four hours.
• Whilst most people find medicines such as diazepam sedating, a small number of people become agitated, aggressive or confused. These medicines can also cause disinhibition and lead to abnormal behaviours. This could impact your safety as well as that of other passengers.
• According to the prescribing guidelines doctors follow (British National Formulary) diazepam is not recommended in treating phobic states. It also states that “the use of benzodiazepines to treat short-term ‘mild’ anxiety is inappropriate.”  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.
• NICE guidelines suggest that these medications are only advised for short-term use for a crisis in generalised anxiety disorder, in which case a person is not fit to fly. Fear of flying in isolation is not a generalised anxiety disorder.

We recognise that fear of flying is real and frightening and we don’t underestimate the impact it can have.

There is a lot of information from the aviation industry on the fear of flying, and most major airlines offer courses for fear of flying. You may find some of the links below useful.