We do not prescribe diazepam or similar sedatives for fear of flying or for dental procedures. The reasons are explained below.
Fear of flying
Our concerns around using diazepam in patient who are nervous about flying are as follows:
- Diazepam is a sedative, which means it makes you sleepy, more relaxed and can significantly delay your reaction times. If there is an emergency during the flight it may impair your ability to concentrate, follow instructions and react to the situation.
- 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. There is concern this can cause you to be at increased risk of developing a blood clot (DVT) in the leg or even the lung which can be dangerous. This risk is greater if your flight is greater than four hours.
- Whilst most people find sedative medications like diazepam have a relaxing effect, a small number of people can actually feel more agitated or even aggressive after taking it. Diazepam can also cause disinhibition and lead you to behave in a way that you would not normally.
- Prescribing guidelines doctors follow (known as the BNF), don’t recommend using benzodiazepines like diazepam in phobias. We would be acting against these guidelines if we prescribe.
- Diazepam and similar drugs are illegal in several countries. They may be confiscated, or you may find yourself in trouble with the police if you are carrying any on arrival.
- Diazepam stays in your system for quite a while. If your job requires you to submit to random drug testing, you may fail this having taken diazepam.
We appreciate that fear of flying is very real and very frightening. A lower risk approach is to tackle this properly and hopefully permanently, with a Fear of Flying course run by the airlines and we have listed a number of these below or there are also some free online courses:
Dental procedures
If you need sedation for dental treatment, your dentist is responsible for prescribing it.
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. Dentists do not have EPS.
If the dentist is treating a patient privately, they should issue a private prescription.
Dentists may contact a GP for information or advice, if, for example the patient has a complex medical history.
