Sedative Prescribing for Flying Phobias

People often come to us requesting diazepam for fear of flying or assisting with sleep during flights. Diazepam in the UK is a Class C/Schedule IV controlled drug.

Mayford House Surgery does NOT prescribe sedatives for fear of flying. There are a number of very good reasons why prescribing this drug is not recommended.

  1. Diazepam is a sedative, which means it makes you sleepy and more relaxed. In the event of 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 for you and those around you.
  2. Sedative drugs can make you fall asleep, however when you do sleep it is an unnatural non-REM sleep. This means you won’t move around as much as you would during natural sleep. This can cause you to be at increased risk of developing a blood clot (DVT) in the leg or even the lungs. Blood clots are very dangerous and can even prove fatal. This risk is even greater if your flight is greater than four hours.
  3. There is a statistically significant reduction in oxygen saturation in all passengers travelling long haul and short haul flights. High-altitude flights make it difficult to saturate the blood with oxygen because the cabin pressure is very low. In such moments, oxygen-carrying blood cells do not perform their duties adequately resulting in the tissues to be fed with less oxygen. Healthy individuals may not be affected by low cabin pressure at high altitudes; but patients with lung or heart problems may experience visual impairment, respiratory failure, shortness of breath or loss of consciousness.
  4. Whilst most people find benzodiazepines like diazepam sedating, a small number react in a contradictory manner and become agitated or even aggressive. The drugs can also cause disinhibition and lead you to behave in a way that you would not normally. This could impact on your safety as well as that of other passengers and could also get you into trouble with the law.
  5. According to the prescribing guidelines doctors follow, Benzodiazepines are contraindicated (not allowed) in phobia. Your doctor would be taking a significant legal risk by prescribing against these guidelines. They are only licensed short term for a crisis involving generalised anxiety i.e. not specific to flying. If this is the case, you should be getting proper care and support for your mental health and not going on a flight.
  6. Diazepam and similar drugs are illegal in a number of countries. They may be confiscated or you may find yourself in trouble with the police.
  7. Diazepam stays in your system for quite a while. If your job requires you to submit to random drug testing you may fail this having taken diazepam.

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 and we have listed a number of these below. This decision has been made by the GP Partners and is adhered to by all prescribers working in the practice.

Fear of Flying Courses

Easy Jet
A free downloadable e-book is available or on line courses from £89
Tel: 0203 8131644

British Airways
Online courses are available from £79.99
Tel: 01252 793 250

Virgin Atlantic
Face to face courses are available at various airports with prices from £267
Tel: 01423 714900 1252250