Fear of Flying

Fear of Flying and Requests for Sedative Medication

We understand that many people experience anxiety about flying, and it is common for patients to ask for sedative medication (such as diazepam) to help manage this.

Below, we explain why this decision is in place, based on patient safety, clinical guidance and legal considerations.

Why do we not prescribe sedatives for flying

Safety on board

• Sedatives slow reaction times, impair 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.

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 hypoventilation. At altitude, where oxygen levels are already lower, this effect may become more significant.
• Some people may experience contradictory 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 significant 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 discussing this with your GP to explore the most appropriate and safe support.

If you would like further advice, a private travel clinic may be able to help guide you on the safest and most effective way to manage your fear of flying.