Why We No Longer Prescribe Diazepam for Fear of Flying
We understand that fear of flying can be very distressing. However, our practice no longer prescribes diazepam (Valium) or similar sedative medications for this purpose. This decision is based on clinical guidance, safety concerns, and legal implications.
Benzodiazepines like diazepam are not recommended in national prescribing guidelines for managing specific phobias, including fear of flying. The British National Formulary (BNF) states that they are not appropriate for treating phobias or short-term, mild anxiety. Prescribing them for flight anxiety would go against this guidance and could place both patient and prescriber at risk.
There are also safety concerns. Diazepam can cause drowsiness, slower reaction times, and reduced alertness. In the event of an emergency during a flight, this could significantly impair your ability to respond and put both you and others at risk. Additionally, some individuals may experience unexpected effects such as agitation, confusion, or aggressive behaviour. This kind of reaction could be disruptive or even dangerous in a confined space like an aircraft cabin. While the sedative effect of diazepam may help some people sleep during a flight, the type of sleep it induces is unnatural and reduces movement. This increases the risk of developing deep vein thrombosis (DVT) — a serious and potentially life-threatening blood clot, particularly on longer flights.
Diazepam is also a Class C/Schedule IV controlled drug in the UK and is tightly regulated internationally. Some countries ban its use altogether. Travelling with it, even with a prescription, can result in confiscation or legal consequences abroad. Another concern is that diazepam has a long half-life and stays in the body for several days. This may result in unexpected positive results on drug testing, which could be an issue for individuals in safety-critical roles or certain professions.
Although the anxiety linked to flying is very real, diazepam is not a safe or appropriate solution. More effective and sustainable options exist. Many airlines offer fear of flying courses that are tailored, practical, and have excellent outcomes. Psychological therapies, such as cognitive behavioural therapy (CBT), are also proven to help manage this type of anxiety in the longer term.