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

[doyouhavefaithingodabove]

I have always been a nervous flier and nervous traveller in general. It makes me very stressed and I tend to not relax until I’ve landed.

I usually fly BA since they’ve introduced WiFi because I can then connect to it and text my dad, who is the only one who’s able to explain things in a way that calms me down. He doesn’t mind it.

This summer I’m flying with Ryanair and the recent news about the window shattering has genuinely made me so anxious I feel sick. I don’t fly for another eight weeks but I can already feel panic building whenever I think of it.

I know this is commonplace in America but does this type of thing ever happen in the UK? Would I need to see a private GP?

Years ago I used to get diazepam, but they won’t now as they say you need to be fully with it in case of an emergency.
However, I injured my back a day before a long haul flight recently and they prescribed diazepam for the pain to get through that, so, you might be able to find a way through.

exactly. Point 1. A small amount of diazepam doesn’t render you useless and flying is the safest mode of transport in the world so this is bullshit.

point 2. You can get around it if you have a supportive doctor but you have to lie

if neither of these are an option

1. propranolol stops physical symptoms of anxiety and almost all doctors will happily prescribe
2. wine. Lots of wine (which renders you more incapable than diazepam but, hey , let’s not let’s common sense get in the way eh?)

Ask GP for propanolol
it’s a beta blocker that reduces symptoms of anxiety
not sedating / or addictive etc
trial it before you fly so you know what the effect feels like

I genuinely could not care less about that.

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.

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.

You wouldn’t be liable for someone taking anti-anxiety meds on a plane

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.

If I had prescribed them, of course I would.

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

No you wouldn’t!

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.

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.’

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!)

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.

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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.

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

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’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

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

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.

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.

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.

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?

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

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.