Benzodiazepine Prescribing Policy

After very careful consideration, Chiswick Medical Practice has reviewed its approach to benzodiazepine prescribing.

We do not prescribe benzodiazepines or sedatives (such as diazepam) for fear of flying, sleep during flights, or for general anxiety. Many other GP practices have adopted the same stance.

Benzodiazepines are associated with significant risks including addiction, withdrawal symptoms, impaired memory and concentration, slower reaction times, paradoxical agitation, increased risk of blood clots when immobile, and dangerous interactions with alcohol. Diazepam is also a Class C / Schedule IV controlled drug in the UK and is illegal to carry in some countries. Clinical guidelines (BNF and NICE) do not support their use in phobic states or in mild anxiety.

For these reasons, our practice does not prescribe benzodiazepines for flying anxiety or routine anxiety management.

Exception – extreme circumstances

In rare and extreme clinical circumstances, benzodiazepines may be considered but the decision to prescribe will always remain with the GP who is being asked to prescribe.

If a hospital consultant or specialist believes you need this medication, they are able to prescribe it themselves as part of your care.

Alternatives for flight anxiety

We recommend structured aviation-approved flight anxiety courses instead of medication, for example:

Flight anxiety does not fall under General Medical Services as defined in the GP contract. Patients wishing to take benzodiazepines for travel purposes will need to consult a private GP or travel clinic.

It is important to declare all medical conditions and medications to your travel insurer, otherwise there is a risk of invalidating your policy.

For further information/References:

  • Generalised anxiety disorder and panic disorder in adults: management. NICE Clinical guideline [CG113] Published date: January 2011 Last updated: July 2019 https://www.nice.org.uk/guidance/cg113
  • Acute and delayed effects of Alprazolam on flight phobics during exposure. Behav Res Ther. 1997 Sep;35(9):831-41