To ask how possible it is to get a prescription for a fear of flying?

Factually incorrect.

If a Doctor prescribed a medication for a use which is contra-indicated /against guidance and something goes wrong, then yes we can be held professionally liable.

it is true that if you were prescribed diazepam for something else- for example, muscle spasm- and you then took it before flying, and the prescribing doctor had no knowledge (or could not reasonably have been expected to know) that you were planning on doing so when they issued the prescription, then they would not be held accountable.

I always have, and still get prescribed diazepam for flying.

They only give me a prescription of 10 tablets maybe 3 times a year so no worry that I’m addicted or overusing!

Again, I will say that your point is irrelevant to mine. I did not write the clinical guidance, nor did I express an opinion one way or the other with regard as to whether I personally agree with the guidance. I was simply explaining why doctors are now unlikely to prescribe benzodiazepines for flying- that being because clinical guidelines are very clear that it is contra-indicated. I was trying to be informative (and potentially saving OP from wasting her money on a private GP).

As to your point re alcohol-related flight disruption, I agree that it is indeed an issue which I think the airlines need to resolve. I would very surprised if there is not a safety issue there too. However, I don’t think that nullifies the risk of other things. If medication is a safety issue, it should be addressed regardless of other safety issues that are also present.

Clinical guidelines have no bearing on alcohol use when flying. It’s not something clinical prescribing guidelines have any influence over. Therefore, is irrelevant with regards to whether or not benzodiazepines should be used. That alcohol is problematic is a separate matter- but that does not mean that benzodiazepine use during flight is fine because alcohol is allowed. If it is true that there is a sufficient risk that the conclusion drawn is that it should just not be used during flight, then that should stand without reference to the question of whether alcohol should be prohibited before and during flights.

Bit snippy! I didn’t write the guidance. I’m just telling you the reason Dr’s generally won’t prescribe benzodiazepines for fear of flying (and those that do are doing so against guidance).

I believe the guidelines came about after a specific incident but I may be misremembering.

Personally, I think alcohol use before/during flying should be restricted- but that isn’t within the realms of medical prescribing guidance, as it’s not a prescription medication. It is, of course, within the aviation industries ability to formally manage.

Your point is, in my opinion, simply “whataboutery”. Yes, alcohol causes issues and I agree limits on how much alcohol you can drink/complete ban before flying would stamp on alcohol-fuelled idiocy and abuse which would be practically helpful and more than likely improve safety (and working conditions for airport and airline staff, I should think). That doesn’t mean benzodiazepine use during flying should not also be addressed, if it is also a potential safety issue. They are linked in terms of both being a potential safety problem, but distinct and standalone within that.

in my opinion this isn’t a gender issue or an example of misogyny. Not everything that disproportionately affects women is an attack on us. It’s an unhelpful trend, as far as I am concerned, because undermines actual examples of misogyny and unfairness.

Yet being being heavily intoxicated on alcohol is absolutely fine, as long as you're not making a ruckus of course...🤔

So….what about the actual hundreds of people each year who stop flights because of alcohol (mostly men)? No, it’s mostly women who need diazepam (proven fact)who are the issue eh?

It’s not about addiction/benzodiazepine dependence. Yes, escalating it frequent use of diazepam is to be avoided but that’s not the reason why guidance state benzodiazepines use is contra-indicated for flying.

It’s because of delayed reaction times/drowsiness if something were to happen during the flight.

For all those saying 'You'll have to go private'- my private health provider won't prescribe diazepam either. Its the airlines who've said they don't want people sleepy on the planes because it poses a risk during an emergency

It's certainly not fair to blame individual GPs.and AFAIK the pressure has come from above the airlines, it's come from the industry regulator, in the UK's case the CAA.

Their specialist medics have presumably seen something they don't like, maybe in incident reports, and have issued guidance.

Agreed, and betablockers have more side effects - my husband took a low dose for a heart issue and had terrible debilitating headaches, I didn't want to risk that, especially not when travelling for work.

Depending on where you are going, take the train, ferry and/car? Why make yourself so upset

i’m a Dr. Any Dr who prescribed a sedative (such as diazepam, which is commonly requested) for fear of flying would be going against all current aviation and medical guidance. The guidance is very clear in this. And it’s national clinical and aviation guidance, not just NHS so does apply to private Dr’s too.

You might find a Dr who chooses to ignore the guidance, but they are leaving themselves wide open to criticism in the event of adverse outcome.

There is good reason- sedation makes you feel calmer but it also slows and dulls reaction (more significantly so for some people than others)- this means in an emergency that you might not be able to respond normally, potentially putting yourself and perhaps others in a dangerous situation.

you might have time to do some of the online cbt that airlines offer. In not for everyone but can help others. There are a few about, for example, https://flyingwithconfidence.com

Those were the years I could fly, when I could get diazepam. Propranolol isn’t helpful as they stop physical but not mental symptoms.

small prescriptions of diazepam are not problematic. If people abuse them then that’s different. Just like people abuse alcohol eh….

I had a dreadful flight once and developed a fear of flying. For a few wonderful years, I was prescribed diazepam. Once or twice a year (I fly regularly for work) I'd take half of a tablet of a low dose, and it took the fear away and made me slightly sleepy. Now the NHS won't prescribe - but they WILL prescribe betablockers which will lower your heart rate and stop physical symptoms such as palpitations or hyperventilating.
For all those saying 'You'll have to go private'- my private health provider won't prescribe diazepam either. Its the airlines who've said they don't want people sleepy on the planes because it poses a risk during an emergency.
Other advice: a drowsy antihistamine. No caffeine. Alcohol, but not too much. Listen to music or a meditation AND keep your hands busy - I knit, but writing or doing a crossword could help just as well. Don't be afraid to tell the flight attendances you're a nervous flyer.
It'll all be okay, and you will be safe <3

I’m a Gp and work in both NHS and private, my private employers don’t allow diazepam prescribing either, as it’s a controlled drug with different restrictions to normal prescribing. All prescriptions of diazepam and sleeping tablets are now heavily discouraged. Doctors are responsible for their prescribing and adverse outcomes that can result from them.

Promethazine is a good alternative that you don’t need a prescription for. I am a psychiatric nurse and we use it for anxiety and agitation.

click2pharmacy.co.uk/product/phenergan-tablets/?gad_source=1&gad_campaignid=23358186467&gbraid=0AAAAACw5t2A4JDKzVVv9C7QEtm8vDbgJI&gclid=CjwKCAjw08fSBhA7EiwAfbQTsO4Iick55HPU3tuKOJGI6g1UZQahdOVZ_RYwXPJr5Xqpu9tn6UuysBoCGRIQAvD_BwE

It's not just that diazepam might impair your ability to function in an emergency that is the problem. Diazepam can reduce inhibitions and lead to irrational behaviour in a similar way to alcohol.
Our GPs had a very strict letter from their professional insurers telling them they might be legally liable for airline costs incurred if someone behaved badly leading to an unscheduled landing, rerouting, etc and the person claimed it was due to diazepam they had prescribed (and of course the patient would admit to that before admitting the vast quantity of alcohol imbibed!)

This is from the NHS guidance link on fear of flying which a PP posted above:

• ‘Guideline Restrictions: The British National Formulary (BNF) contraindicates the use of Diazepam for treating phobic states and discourages its use for short-term, mild anxiety. Prescribing against these guidelines may expose your doctor to legal liability.’

Grow up. You don’t ’have to think’ about any of these things. You do as you’re told. How many people, ever, in the course of history have been hindered escaping a plane emergency because of someone else having taken diazepam? I’ll help you. Zero. It’s just a fear of litigation which has a disproportionate real world affect on those with a fear of flying.

Agree that is bonkers !!
many reasons why people may be slow / uncooperative / etc
medication / alcohol / medical conditions

If I had prescribed them, of course I would.

I’m not a great flyer but have just come back from a 4 hour flight. I bought some OTC anti histamines took them put on eye mask and loop ear plugs, even though it was a daytime flight, and woke up on landing. Will always do that in future now.

Do you also not care about the people sat near you whose exit from the plane you might slow down because of your reduced responses?

As a GP I have to think about lots of things when I prescribe and one of them is whether anything I prescribe might affect your safety or anyone else’s. There is potential for me to be liable if so.

Was just coming to say beta blocker propranol which I take for situational anxiety, this won’t make you drowsy but will stop the panicky feeling in your body. I can the poster above has also advised this.