Brunton Park Health Centre – Practice Policy
Requests for Benzodiazepines for the indication of Fear of Flying
At Brunton Park Health Centre, our practice stance is not to prescribe any Benzodiazepines for the indication Fear of Flying
Reasoning behind this:
- In flight Safety:
- Benzodiazepines can cause CNS depression which slows thinking and reaction times. This can increase the risk to the passenger if they are unable to act in an emergency situation, which could put them at a significant risk of not being able to save their life.
- According to the BNF, benzodiazepines can (although uncommonly) cause agitation, which could increase the risk to other passengers and staff.
- Although the medical advice is not to drink alcohol alongside benzodiazepines, the reality is this may not be followed, and cause adverse effects.
- VTE risk
- As benzodiazepines have the potential to cause CNS depression, there is an increase risk of developing DVT/PE, which can be fatal. According to research, benzodiazepines have the potential of inducing non-REM sleep which is where a person does not move in their sleep. If a flight is 4 hours or more and the person does not move in this time because they are in this type of sleep, then this further increases their VTE risk
- CNS Depressant Effect
- Benzodiazepines have sedating effects, which can cause oxygen saturations to decrease. This is dangerous as oxygen saturation levels are already reduced at altitude.
- Law in Other Countries
- In some countries, benzodiazepines are illegal and a patient risks breaking the law if found to be carrying this. Also in some countries where it is illegal, passengers will need to consider the return flight home/onward journey and will need an alternative way of coping with flying
- GPs are only indemnified for medicines administered within the UK.
- NICE Guidance Stance
- We should not be prescribing benzodiazepines for mild or self-limiting mental health problems and are only advised for short term use in a crisis in generalised anxiety disorder. For this indication, a person would not be fit to fly. Fear of flying is not generalised anxiety disorder.
- Phobia is listed as a contraindication for prescribing Benzodiazepines.
- Alternative Signposting
- A number of airlines offer information or courses on Fear of Flying via the internet – it could be suggested to the patient to contact their airline provider to see if this is offered but to warn their may be an associated cost to them.
EasyJet – Fear of flying course | Fearless Flyer (easyjet.com)
British Airways – Flying with Confidence | Special assistance | British Airways
Virgin Atlantic – Tips For Nervous Flyers | Advice For Nervous Flyers | Virgin Atlantic