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Fear of Flying and MRI Scan Policy
Prescribing of Benzodiazepines and Sedatives for Fear of Flying and MRI Scans
Elizabeth House Medical Practice does not prescribe benzodiazepines or other sedative medicines (such as diazepam, lorazepam or temazepam) for:
- Fear of flying
- MRI scans
- Dental procedures
- Other routine medical procedures where sedation is requested solely to reduce anxiety.
This policy applies to all clinicians within the practice.
Fear of flying and anxiety associated with MRI scans or other routine procedures are not NHS-funded indications for prescribing sedative medication in primary care. GP practices are therefore not commissioned to prescribe these medicines solely for these situations. Our policy reflects current national guidance and our commitment to safe, evidence-based prescribing.
Why don't we prescribe these medicines?
Although medicines such as diazepam can make people feel sleepy or less anxious, they also carry significant risks.
1. Safety during emergencies
Benzodiazepines reduce concentration, judgement and reaction times. If an emergency occurs during a flight or another situation requiring a rapid response, sedation may impair your ability to understand instructions, respond appropriately and evacuate safely. This could put both you and those around you at risk.
2. Increased risk of blood clots (DVT)
Sedative medicines often cause an unnatural, non-REM sleep, during which people move much less than they do during normal sleep. Reduced movement during flights - particularly those lasting longer than four hours - increases the risk of developing deep vein thrombosis (DVT), which can occasionally lead to life-threatening complications such as pulmonary embolism.
3. Unexpected side effects
Whilst many people become sleepy after taking benzodiazepines, some experience the opposite effect. They may become agitated, restless, aggressive or disinhibited, causing them to behave in ways they would not normally. This can affect personal safety and, on an aircraft, may also affect other passengers and crew.
4. National prescribing guidance
The British National Formulary (BNF) advises that benzodiazepines are not recommended for the treatment of phobic states, including fear of flying. NICE guidance also recommends that benzodiazepines should not routinely be prescribed for anxiety disorders except in limited clinical circumstances, such as short-term use during an acute crisis in generalised anxiety disorder.
5. Dependence and side effects
Benzodiazepines are controlled drugs and can cause tolerance, dependence and withdrawal symptoms. They can also interact with alcohol and other medicines, increasing the risk of excessive sedation and other adverse effects.
6. Travelling abroad
Some countries have strict regulations regarding benzodiazepines and other controlled medicines. They may be prohibited, require specific documentation or be confiscated on arrival.
7. Drug testing
Diazepam can remain detectable in the body for several days and may affect workplace or occupational drug screening where this is undertaken.
MRI scans and other medical procedures
We understand that many patients feel anxious or claustrophobic before an MRI scan.
If sedation is clinically appropriate, it should be assessed and arranged by the hospital radiology department carrying out the scan. Most hospital sites have the facilities to monitor patients safely before, during and after sedation. Similarly, if sedation is required for a dental procedure, this should be arranged by your dentist or specialist dental service.
If you are concerned about an upcoming MRI scan, we recommend contacting the imaging department in advance. They may be able to:
- explain the procedure beforehand
- offer headphones or music
- arrange a wider-bore scanner where available
- allow a friend or relative to accompany you where appropriate
- discuss whether hospital-arranged sedation is clinically appropriate.
What can I do instead?
We appreciate that fear of flying and claustrophobia are genuine conditions that can be extremely distressing. Fortunately, there are effective treatments that help people manage these fears safely and provide long-term benefit.
Fear of Flying Courses
Many airlines run highly successful courses led by experienced airline pilots together with clinical psychologists or anxiety specialists. These include:
- British Airways – Flying with Confidence
- EasyJet – Fearless Flyer
- Virgin Atlantic – Flying Without Fear
Talking therapies
If anxiety or phobias affect other areas of your life, effective treatment is available through:
- NHS Talking Therapies
- Cognitive Behavioural Therapy
- Relaxation techniques, breathing exercises and mindfulnesstics
Our decision
We understand that fear of flying and anxiety around MRI scans can be very real and very frightening. However, our decision not to prescribe sedative medication is based on national guidance, patient safety and responsible prescribing.
We hope you understand that we are unable to make exceptions to this policy. We would be happy to discuss longer-term treatment options if anxiety is affecting your everyday life.