Fear of Flying
After careful consideration, Queens Road Partnership Surgery will no longer prescribe benzodiazepines or other sedatives (such as Diazepam or Zopiclone) for flight-related anxiety or to aid with sleep during air travel. Instead, we recommend exploring flight anxiety courses offered by aviation industry professionals (see resources listed below).
Why We No Longer Prescribe These Medications for Flying
Flight anxiety is not classified as a medical condition that falls under General Medical Services as defined in the NHS GP contract. Therefore, we are not obliged to prescribe medications for this purpose. Patients who still wish to use benzodiazepines while flying are advised to consult a private GP or travel health clinic.
Important Medical and Legal Considerations
Diazepam is a Class C controlled drug in the UK. Due to its risk of addiction and abuse its prescribing is controlled by UK regulatory bodies. Although it may make you sleepy and more relaxed, there are a number of reasons why prescribing this drug is not recommended:
- Not Approved for Flight Anxiety- According to the British National Formulary (BNF), Diazepam is not licensed for treating phobias or mild anxiety. Prescribing it in these cases would go against national medical guidelines and place doctors at legal risk. Diazepam is only indicated for short-term use in acute anxiety crises. Flight anxiety on its own does not meet this definition and would suggest the need for broader mental health support—flying in such a state would not be advisable.
- Increased Risk of Blood Clots (DVT) - While sedatives may induce sleep, they lead to non-REM sleep, which reduces natural movement. This immobility increases the risk of developing deep vein thrombosis (DVT), especially on flights longer than four hours. DVT can be life-threatening if a clot travels to the lungs.
- Unpredictable Side Effects - Although, generally sedating, Diazepam and Zopiclone can cause paradoxical reactions in some individuals, including agitation, aggression, or disinhibition. These side effects can pose serious safety risks during a flight, both to the individual and fellow passengers. Similar issues have been observed with alcohol use on board.
- Legal Restrictions Abroad - Diazepam and similar medications are classified as Class C controlled substances in the UK and are illegal in many other countries. Bringing them into certain destinations could result in confiscation or legal penalties. This also creates complications for the return journey if alternative medication arrangements are required.
- Impact on Travel Insurance - It is essential to declare all medications and medical conditions to your travel insurer. Failure to do so may invalidate your insurance policy.
Further information
Thank you for your understanding and cooperation.
Medical Procedures
Queens Road Partnership Surgery has also decided not to prescribe diazepam or any sedative for medical procedures, including MRI scans and dental treatments.
Some patients have previously received prescriptions for sedatives like diazepam to manage anxiety or claustrophobia during these procedures. However, this practice is no longer considered safe, for the following reasons:
- Responsibility: GPs typically do not request MRI scans—these are usually ordered by hospital teams. If anxiety prevents you from attending your scan, please speak to the requesting department, not your GP practice.
- Inappropriate Sedation: GPs are not trained to administer procedural sedation. Administering too little sedation may be ineffective; too much may dangerously depress breathing or consciousness and lead to cancellation of the procedure. Safe sedation requires monitoring, which we cannot provide in general practice.
- Paradoxical Effects: Diazepam can occasionally cause agitation rather than sedation, increasing risk during procedures.
- Delays in Procedure Timing: Hospital procedures and scans are often delayed. The sedation should be provided by the clinical team conducting the scan to ensure effectiveness at the correct time.
- Radiology Safety Guidelines: The Royal College of Radiologists has strict protocols on sedating patients for CT and MRI scans. Prescribing a sedative without on-site monitoring is considered unsafe. If complications arise and the radiology team is unaware of a sedative you’ve taken, this could be extremely dangerous.
- Surgeon or Dentist Responsibility: If sedation is needed for dental treatment or operations (e.g., cataract surgery), it is the responsibility of the treating clinician to provide it. We do not prescribe sedatives for these purposes.
If you are concerned about undergoing a scan or procedure due to anxiety or claustrophobia, please contact the requesting department or radiology service directly.
Further Information