Sedative medication for phobia
Fear of Flying
Due to a medical safety alert from Aviation trained doctors; we have taken the decision to no longer prescribe sedating drugs such as Diazepam, which is sometimes used to treat fear of flying, and medications such as Zopiclone, which is used as a sleeping tablet. There are several very good reasons why prescribing these drugs is not recommended:
1 – Diazepam and Zopiclone are both sedative, which means it makes you more relaxed and sleepier. If there is an emergency during the flight, it may impair your ability to concentrate, follow instructions and react to the situation. This could have serious safety consequences not just to yourself, but to those around you.
2 – Sedative drugs can make you fall into an unnatural non-REM sleep. This means you won’t move around as much as you would do in natural sleep. This can cause you to be at increased risk of developing a blood clot in the leg (DVT) or even the lung. Blood clots are very dangerous and can even prove fatal. This risk is even greater if your flight is greater than 4 hours.
3 – Whilst most people find Diazepam sedating, a small number have paradoxical agitation and increased aggression. It can also cause disinhibition, leading you to behave in a way that you would not normally. This could impact on your safety as well as that of other passengers. A similar effect can be seen with alcohol, which has led to passengers being removed from their flights. It could also get you into trouble with the law.
4 – The British National Formulary (BNF), the reference guide for prescription of medications by doctors in the UK, states that the use of benzodiazepines is not allowed in treating phobia. Your doctor would be taking a significant legal risk by prescribing against these guidelines. They are only licensed short term for a crisis in generalised anxiety. If this is the case, you should be getting proper care and support for your mental health, and not going on a flight.
5 – Diazepam and similar drugs are illegal in several countries. They may be confiscated, or you may find yourself in trouble with the police
Given the above, we will no longer be prescribing Diazepam for flight anxiety or Zopiclone for flight insomnia. We appreciate that fear of flying is very real and very frightening. A much better approach is to tackle this properly with a Fear of Flying course run by the airlines.
We have provided a number of these below - click the links to learn more
Sedation for dental procedures
We will not prescribe benzodiazepines to reduce anxiety ahead of dental procedures. It is important you discuss any concerns/requests for medication to help relax you with your registered dentist.
It is important any sedative drugs are prescribed by the team performing the procedure so they are aware of any measures that need to be taken alongside this.
Sedation for MRI scanning
We understand that having an MRI scan can be worrying and some patients experience claustrophobia within the scanner. Using sedative benzodiazepines is not recommended as per the BNF indications for use (see above in flying section). If a scan is being requested by a specialist e.g. neurology please discuss any sedation with their team.
In some areas, there are open MRI scanners which can be utilised for patients needing a scan who experience severe claustrophobia. Hospital Specialists are in a better place than GPs to judge and administer prescriptions for sedation if there are exceptional grounds. Sedation for other specialist tests/treatments
We would not prescribe sedative medication ahead of other tests or treatments, it is important that your specialist team oversee and prescribe anything they feel appropriate
Full policy > here
