Patients come to us, asking us to prescribe diazepam for fear of flying. There are a number of very good reasons why prescribing this drug is not recommended.

• Diazepam is a sedative, which means it makes you sleepy and more relaxed. If there is an emergency during the flight it may impair your ability to concentrate, follow instructions and react to the situation. This could have serious safety consequences for you and those around you.
• Sedative drugs can make you fall asleep, however when you do sleep it is an unnatural non-REM sleep. This means your movements during sleep are reduced and this can place you at increased risk of blood clots.  These blood clots are very dangerous and can even prove fatal.  This risk increases further if your flight is over four hours long. 
• Although most people respond to benzodiazepines like diazepam with sedation a small proportion experience the opposite effects and can become aggressive.  They can make you behave in ways you normally wouldn’t.  This could also impact on your safety and the safety of your fellow passengers or could lead you to get in trouble with the law. 
• According to the prescribing guidelines doctors follow (BNF), benzodiazepines are contraindicated (not allowed) in treating phobia. 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.
• In several countries, diazepam and similar drugs are illegal.  They would be confiscated, and you might find yourself in trouble with the police for being in control of an illegal substance. 
• 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 much better approach is to tackle this properly with a Fear of Flying course run by the airlines. We have listed a number of these below.