Fear of Flying

After careful consideration, we will no longer prescribe benzodiazepines or sedatives (such as diazepam) for patients experiencing fear of flying. Many other GP practices have adopted similar policies.

Patients sometimes request diazepam to help manage a fear of flying or to aid sleep during flights.

The following guide outlines why this medication is no longer prescribed by our practice for flying-related anxiety:

Why Diazepam Is Not Prescribed for Flying Anxiety

Safety Risk in Emergencies: Benzodiazepines cause delayed reaction times and slower thinking. In the event of an in-flight emergency, this could impair your ability to respond appropriately, putting your safety—and that of others—at risk.

Increased Risk of Blood Clots: Although Diazepam may help you fall asleep during a flight, it induces non-REM sleep, which reduces natural movement. This immobility increases the risk of blood clots (deep vein thrombosis, or DVT), particularly on flights longer than four hours. Such clots can be life-threatening.

Paradoxical Reactions: While Diazepam is usually sedating, a small percentage of individuals experience the opposite effect: agitation, aggression, or disinhibition. These behaviours could endanger yourself and others, and may lead to legal consequences.

Increased Risks with Alcohol: The combination of benzodiazepines and alcohol magnifies all the risks outlined above.

Guideline Restrictions: The British National Formulary (BNF) contraindicates the use of Diazepam for treating phobic states and discourages its use for short-term, mild anxiety. Prescribing against these guidelines may expose your doctor to legal liability.

NICE Guidance: According to NICE guidelines, medications should not be used for mild, self-limiting mental health disorders. In more significant anxiety-related conditions, benzodiazepines, sedating antihistamines, or antipsychotics are also not recommended.

Legal Risks Abroad: In some countries, including parts of the Middle East, it is illegal to import benzodiazepines. They may be confiscated, and you could face legal repercussions.

Workplace Drug Testing: Diazepam remains in your system for an extended period. If your employment involves drug testing, you could fail a test after taking it.

Link to Dementia: Long-term benzodiazepine use has been associated with an increased risk of developing dementia.