Advice for Patients

Requests to Prescribe Sedative medication prior to Flying or Medical/Dental Procedures

People often come to us requesting the doctor or nurse to prescribe diazepam for fear of flying or assist with anxiety and sleep during flights and procedures. Diazepam is a sedative, which means it makes you sleepy and more relaxed. There are several very good reasons why prescribing this drug is not recommended.

According to the prescribing guidelines doctors follow (British National Formulary) diazepam is contraindicated (not allowed) for treating phobias (fears). It also states that “the use of benzodiazepines to treat short-term ‘mild’ anxiety is inappropriate.” Your doctor would be taking a significant legal risk by prescribing against these guidelines. They are only licensed short term for a crisis in generalised anxiety. If this is the case, you should be getting proper care and support for your mental health and not going on a flight. Fear of flying in isolation is not a generalised anxiety disorder.

Although plane emergencies are a rare occurrence there are concerns about reduced awareness and reaction times for patients taking Diazepam which could pose a significant risk to themselves and others due to not being able to react in a manner which could save their life in the event of an emergency on board necessitating evacuation.

The use of such sedative drugs can make you fall asleep, however when you do sleep it is an unnatural non-REM sleep. This means you won’t move around as much as during natural sleep. This can cause you to be at an increased risk of developing a blood clot (Deep Vein Thrombosis – DVT) in the leg or even the lungs. Blood clots are very dangerous and can even prove fatal. This risk is even greater if your flight is greater than 4 hours, the amount of time which has been shown to increase the risk of developing DVT whether in an aeroplane or elsewhere.

Whilst most people find Diazepam sedating, a small number have paradoxical agitation and aggression. They can also cause disinhibition and lead you to behave in a way that you would not normally which can pose a risk on the plane. This could impact on your safety as well as that of other passengers and could also get you into trouble with the law. A similar effect can be seen with alcohol, which has led to people being removed from flights.

Diazepam and similar controlled drugs are illegal in a number of countries. They may be confiscated, or you may find yourself in trouble with the police. The passenger may also need to use a different strategy for the homeward bound journey and/or other legs of the journey. 
It is important to declare all medical conditions and medications you take to your travel insurer. If not, there is a risk of nullifying any insurance policy you may have.

Flight anxiety does not come under the remit of General Medical Services as defined in the GP contract and so we are not obliged to prescribe for this.  Patients who still wish to take benzodiazepines for flight anxiety are advised to consult with a private GP.

Prescribing for Dental Procedures

• GPs will not issue prescriptions for sedating medications (such as diazepam) prior to dental procedures.
• Dentists should not direct patients to GPs requesting they prescribes sedating medications, such as diazepam.  

If a dentist wishes to prescribe sedating medications for anxious patients that dentist should be responsible for issuing the prescription. The dental practitioner’s formulary, which is the list of drugs a dentist can prescribe is found on the BNF dental practitioners formulary, includes Diazepam Tablets and Oral Solution.  

• If the dentist is treating a patient within their practice NHS contract, then the prescription should be on a FP14D form. 
• If the dentist is treating a patient privately, they should issue a private prescription.   Dentists can access a patient’s summary care record via the DERs/Rego electronic referral system for NHS England Southeast dental referrals.  
• Dentists may contact a GP for information or advice, if, for example the patient has a complex medical history. 

Prescribing for other procedures eg Claustrophobia during Scans

GPs will not issue prescriptions for sedating medications (such as diazepam) prior to MRI scans.

It’s estimated that every year, approximately two million MRI scans worldwide are not performed because of patients refusing to be scanned or terminating the scan early due to claustrophobia. 

There are many resources online that can help prepare patients on what to expect during a scan including step by step explanations and videos of MRIs being performed.  In more severe cases, the NHS website suggests that mild sedatives are an option for people with severe MRI anxiety. However, the MDU would recommend members to carefully consider the 2018 Royal College of Radiologists’ guidance, Sedation, analgesia and anesthesia in the radiology department, which states that a ‘trained and credentialed team should administer sedation and analgesia.’ 

There is also an emphasis on thorough pre-procedure assessment, planning and monitoring. 

This means that the GP is not the right person to prescribe these medications. If they are needed, then this needs to be discussed with the radiology team. 

Given the above we will not prescribe Diazepam or similar drugs for flight anxiety or medical dental procedure related anxiety. Please find some resources regarding flight anxiety below:

For further information:

• Easyjet
• British Airways

Published: May 9, 2025