Diazepam

We understand that people have anxiety about flying and may request sedatives such as diazepam to help with this.

As a practice, we do not prescribe diazepam for flying.

Why we do not prescribe diazepam for flying

Safety on board

  • Diazepam slows reaction times, impairs decision making and coordination. In the rare event of an in‑flight emergency, this could put both the passenger and others at risk.
  • They can also cause significant drowsiness, which may make evacuation in an emergency more difficult. Even if it has never been an issue in the past, people can react differently over time.

Medical risks

  • Sedatives increase the risk of deep vein thrombosis (DVT), especially on longer flights, as they reduce movement during sleep.
  • They can affect breathing by causing mild respiratory depression. At altitude, where oxygen levels are already lower, this effect may become more significant.
  • Some people may experience paradoxical effects, such as agitation or aggression, rather than calm.

Guideline and clinical reasons

  • Benzodiazepines (e.g. diazepam) are not recommended for phobias, including fear of flying, in the British National Formulary (BNF).
  • NICE guidelines advise against using sedative medication for mild or short‑term anxiety.
  • Fear of flying is considered a specific phobia, not generalised anxiety disorder, so these medicines are not indicated.

Other important considerations

  • Combining sedatives with alcohol (often consumed by nervous flyers) increases the risk of complications.
  • Importing or carrying sedative medication is illegal in some countries, which could cause problems when travelling abroad.
  • Sedatives carry a risk of dependence and, with regular use, may be linked to cognitive side effects.
  • GP indemnity generally only covers prescribing for use in the UK; use during travel abroad may not be covered.

What you can do instead

Fear of flying is common, and there are safer, evidence‑based approaches to help manage it:

  • Fear of flying courses, often run by airlines, which combine education about flying with anxiety management techniques.
  • Cognitive behavioural therapy (CBT), which has good evidence for helping with specific phobias.
  • Self‑help strategies such as breathing exercises, distraction (music, reading, puzzles) and talking openly to cabin crew about your anxiety.

Below are some courses and resources you may find useful:

Guidance from the UK Civil Aviation Authority (CAA)

The CAA advises that sedative drugs are not recommended for fear of flying, for the same safety and health reasons outlined above.
They encourage passengers to consider therapeutic options, self‑help techniques and to seek professional advice before flying.

If you feel your anxiety is severe or part of a wider mental health condition, we recommend completing a routine healthcare request to explore the most appropriate and safe support.

With thanks to Southgate Medical Group for their information.

Diazepam for other reasons

We have similar requests for prescribing of diazepam for fear of scans, dentists and other phobias. We also do not prescribe diazepam for any of these reasons. Diazepam increases the risk of falls, can cause breathing difficulties (especially if you have a pre-existing condition), and we cannot monitor how you will respond.

If you have anxieties related to dental treatment, please discuss with your dentist who may feel diazepam is appropriate. They are permitted to prescribe this for you as part of the dental formulary, but we cannot do it on their behalf, even if they suggest it. Likewise, if you need a scan that makes you claustrophobic (e.g. CT or MRI) then ask the person who is requesting the scan whether a sedative is possible. GPs are not permitted to request CTs or MRIs, and we do not prescribe on behalf of hospital consultants.

Support for specific phobias can be accessed via NHS Talking Therapies self-referral and this is much better than medication as it treats the cause of the issue.