Fear of flying medications

Some patients ask their GP to prescribe medications such as diazepam or other benzodiazepines to help with anxiety when flying.

Vine Medical Group do not prescribe benzodiazepines (such as diazepam, lorazepam or temazepam) for fear of flying.

This policy is based on national prescribing guidance, aviation medicine advice and patient safety considerations.

British National Formulary (BNF) Guidance

The British National Formulary (BNF), which provides prescribing guidance for clinicians in the UK, advises that benzodiazepines:

  • Should not be used for the treatment of phobic states
  • Are not appropriate for short-term use in mild anxiety

Fear of flying is considered a phobic or situational anxiety disorder, and therefore prescribing benzodiazepines for this purpose would go against BNF guidance. Prescribing medication outside established national guidance may also expose the prescriber to potential medico-legal liability, which is another reason these medications are not issued for this indication.

Aviation Medicine Safety Concerns

Advice from Aviation Medicine highlights several safety concerns regarding the use of sedative medications during flights.

Reduced ability to respond in an emergency

Benzodiazepines slow reaction times and impair concentration. In the event of an in-flight emergency requiring rapid evacuation or instructions from cabin crew, sedation may reduce a passenger’s ability to respond appropriately.

Increased risk of Deep Vein Thrombosis (DVT)

Sedative medications can cause unnatural sleep and prolonged immobility. This may increase the risk of developing blood clots in the legs (deep vein thrombosis) during long flights.

Reduced breathing and oxygen levels

Benzodiazepines depress the central nervous system and can reduce breathing rate. Aircraft cabins already operate at lower oxygen levels than ground level, which may increase the risk of breathing difficulties in susceptible individuals.

Paradoxical reactions

Although uncommon, benzodiazepines can cause unexpected paradoxical reactions, including:

  • agitation
  • aggression
  • disinhibition
  • confusion

These reactions can be distressing and may create safety concerns on board an aircraft.

Interaction with alcohol

Alcohol consumption during flights can significantly increase the sedative effects of benzodiazepines, which may lead to excessive sedation, impaired breathing or behavioural disturbance.

Legal restrictions in other countries

Benzodiazepines are controlled drugs in many countries. Carrying these medications without appropriate documentation may lead to problems with customs or local authorities.

Dependence and Safety Concerns

Benzodiazepines carry recognised risks, including:

  • dependence
  • tolerance
  • withdrawal symptoms
  • impaired coordination and memory

For these reasons their use is carefully restricted in modern medical practice.

Alternatives for Fear of Flying

There are effective non-medication approaches available to help people manage a fear of flying.

Several airlines offer structured courses that combine education about aviation safety with psychological techniques to manage anxiety. Examples include:

These programmes are widely recommended and can provide long-term strategies for managing flight anxiety.