August 2025
WMG position
WMG clinicians will not prescribe benzodiazepines to ease anxiety associated with air travel.
General principles behind this position
Benzodiazepines are contraindicated in phobic states (see BNF, Diazepam | Drugs | BNF | NICE)
Specific considerations regarding air travel
- The use of any sort of central nervous system (CNS) depressant causes longer reaction times & slowed thinking, which during a flight will put the passenger at significant risk of not being able to act in a manner which could save their life in the event of a safety critical incident
- The use of any sort of CNS depressant has potential to increase the risk of DVT – these drugs can induce non-REM sleep which tends to be of a type where the person does not move in their sleep, and therefore increases the possibility of sitting without moving for long periods of time.
- The sedating effects have the possibility of causing some respiratory depression, resulting in a drop in oxygen saturations.
- A paradoxical increase in aggression may be reported by patients taking benzodiazepines (see BNF) & therefore has potential to put other occupants of the aircraft at risk.
- For some countries it is illegal to import these drugs and so the passenger will need to use a different strategy for the homeward bound journey and / or any subsequent legs of the journey.
- Standard GP indemnity does not cover treatment initiated outside the UK, so the prescriber would only have medico-legal protection for doses to be taken on journeys starting in the UK.
- There is a risk of addiction from inappropriate benzodiazepine use.
- There are good quality fear of flying courses available in the UK which are easily accessible for those who genuinely wish to fly and have a desire to overcome their fear, for example: