Fear of flying

A Medical Safety Alert has advised that we should no longer prescribe the sedating drugs benzodiazepines    e.g. diazepam/ lorazepam/ temazepam, midazolam, for treating fear of flying.

As a result we have decided to put patient safety first and to follow this safety guidance.

For the following reasons we will no longer provide prescriptions for benzodiazepines:

  • The use of any sort of benzodiazepines causes longer reaction times & slowed thinking, which during a flight will put the passenger at significant risk of not being able to act in a manner which could save their life in the event of a safety critical incident, incapacitation from benzodiazepines is a risk to the lives of all on board the aircraft in the event of an emergency requiring evacuation.
  • The use of benzodiazepines has the potential to increase the risk of DVT or PE- these drugs can induce non-REM sleep which tends to be of a type where the person does not move in their sleep, and therefore increases the possibility of sitting without moving for more than 4 hrs (the amount of time which has been shown to increase the risk of developing DVT whether in an aeroplane or elsewhere).
  • The sedating effects can reduce respiratory function, which has the potential to be life threatening – even more so if there is a combination with alcohol.
  • There is the possibility of increased aggression in patients taking benzodiazepines which therefore has the potential to put other occupants of the aircraft at risk.
  • Benzodiazepine use added to alcohol consumption causes an increase in the risk posed by the points above
  • Benzodiazepines are contraindicated in phobic states, and NICE guidelines state that they should not be used for mild & self-limiting mental health conditions. Benzodiazepines are only advised for the short term use for a crisis in generalised anxiety disorder, i.e. acute anxiety emergencies & if this is the case, they would not be fit to fly anyway (potential risk to being able to allow completion of the flight without diversion)
  • In some countries it is illegal to import these drugs, e.g. in the Middle East, and so the passenger will need to use a different strategy for the homeward bound journey and / or any subsequent legs of the journey; 
  • Standard GP indemnity does not cover patients for treatment initiated outside the UK, so you would only be covered for doses to be taken on journeys starting in the UK;
  • Risk of addiction from inappropriate Benzodiazepine use; 
  • Possible risk of early dementia in Benzodiazepine users
  • There are plenty of good quality fear of flying courses available in the UK which are easily accessible by those who genuinely wish to fly & conquer their fear of flying, eg: