Fear of Flying

Posted on June 5th, 2023

As of Monday, July 3rd for safety reasons we will no longer be prescribing Diazepam to patients with a fear of flying.

• The British National Formulary states that “the use of benzodiazepines to treat short-term ‘mild’ anxiety is inappropriate”. 

• Although emergencies in the air are a rare occurrence, there are concerns that the reduced awareness and reaction times of people taking a benzodiazepine would pose a risk if they are not able to act in a manner which could save their life in the event of an onboard emergency such as one necessitating evacuation. 

 • There are concerns about paradoxical agitation; a person taking a benzodiazepine becomes unexpectedly more agitated and violent, which can pose a risk on the plane. A similar effect can be seen with alcohol, which has led to people being removed from flights. 

• Benzodiazepines are not recommended for people with phobic states (and could lead to the phobia worsening with repeated use). A study published in 1997 from the Stanford University School of Medicine showed that there is evidence that use of benzodiazepines stops the normal adjustment response that would gradually lessen anxiety over time and therefore perpetuates and may increase anxiety in the long term, especially if used repeatedly. 

• The sedating effects can reduce respiratory function which has the potential to be life threatening, particularly if combined with alcohol. This risk has the potential to be further  heightened by the effects of the lower oxygen environment when flying at altitude 

• The use of benzodiazepines has the potential to increase the risk of deep vein thrombosis due to reduced movement. 

• For some countries it is illegal to import benzodiazepines and so the passenger will need to use a different strategy for the homeward bound journey and / or any subsequent legs of the journey. 

• The aviation industry recommends flight anxiety courses for people with fear of flying. These are run by several major airlines and sometimes by local airports.

Many Thanks

Sothall Medical Centre