St Luke's Medical Practice
Carluke Community Health Centre
Sedatives for Flying and Medical procedures
We are unable to provide prescriptions for sedatives, like diazepam, for dental and medical procedures and scans taking place in other healthcare settings.
Benzodiazepines, like diazepam, work by making you feel more relaxed and sleepier which can feel like a good thing when facing an anxiety cause procedure. However, they do come with associated risks, especially if the person performing the procedure does not know what you have taken. In some cases, they can actually have the opposite effect causing increased agitation. They can also impair your judgement and lead to drowsiness and light headedness and increase your risk of accidents. Longer term they can lead to issues with dependence (addiction) and tolerance.
When procedures are taking place in other settings it is important for the team performing these to know if you are taking sedative medication and to be able to monitor their effects. It is generally therefore best that the person who is undertaking the procedure is the one prescribing the medication. Dentists are prescribers and can prescribe sedatives if they decide it is necessary. Likewise, for scans and procedures organised by the hospital if you think you may need a sedative you should speak to the requesting or performing team who can decide if this is appropriate or not.
Diazepam and flying
St Luke's Medical Practice has taken the decision to no longer prescribe benzodiazepines, like diazepam, for fear of flying. We understand this may be difficult, particularly for those who have in the past received prescriptions from us, but we have set out some of the reasons behind this decision below.
- Benzodiazepines are sedative drugs; part of the way they work is by making you feel sleepier and more relaxed. Whilst flying there are concerns this could affect behaviour and response times in an emergency, potentially putting yourself, fellow passengers, and crew members at increased risk if they needed to help you instead of dealing with the situation.
- Benzodiazepines may increase your risk of deep vein thrombosis, blood clots in the legs and lungs. They affect sleep quality, leading to more non-REM sleep, meaning your body moves less than during natural sleep. This risk is more likely on flights longer than four hours. Clots like this can make people extremely ill and can at times be fatal.
- Although for most people benzodiazepines cause sedation, they can occasionally cause people to become more agitated and behave in unusual ways. This may lead to problems whilst in airports and on flights.
- Respiratory changes. Oxygen levels even for normal healthy people reduce when up in the air. Benzodiazepines can affect your breathing causing you to breathe less well which might be particularly problematic if you have underlying heart or breathing difficulties already.
- These effects can all be enhanced when taking alcohol which is common on flights and could add to the concerns already discussed above.
- Benzodiazepines are not licensed medications for phobias. This means that GPs could be liable for any adverse effects taken when these are prescribed for this reason. They are not recommended for mild and self-limiting anxiety. They can be used for moderate to severe general anxiety, along with other measures, but in these cases, patients would be unwell and would not be going on flights. Fear of flying is not a generalised anxiety disorder.
- Benzodiazepines are illegal in some countries and so you could find yourselves in trouble with the authorities in these places.
- Driving. Benzodiazepines can take a variable amount of time to get out of your system. Sedative effects can potentially impair driving and increase risk of accidents particularly in people who are new to taking the medication. It may be hard to know when you are safe to drive again particularly as above if combined with alcohol. Different countries have different laws regarding driving with drugs, but you can be tested for this at the roadside.
We appreciate that fear of flying is a genuine and distressing condition which can cause considerable distress. Many airlines offer fit to fly courses which can help with managing this and we would encourage you to look at some of the links below:
https://www.fearlessflyer.easyjet.com/ EasyJet
https://online.flyingwithconfidence.com/ British Airways™