We are no longer allowed to prescribe Diazepam for the following reasons:
Fear of Flying
Safety on board:
Sedatives slow reaction times, impair decision making and coordination. In the rare event of an in-flight emergency, this could put both the passenger and others at risk. They can also cause significant drowsiness, which may make evacuation in an emergency more difficult.
Medical Risks:
Sedatives increase the risk of deep vein thrombosis (DVT), especially on longer flights, as they reduce movement during sleep. They can affect breathing by causing mild respiratory depression. At altitude, where oxygen levels are already lower, this effect may become worse. Some people may experience paradoxical effects, such as agitation or aggression, rather than calm.
Guideline and Clinical Reasons:
Diazepam is no longer recommended for phobias, including fear of flying, in the British National Formulary (BNF). NICE guidelines advise against using sedative medication for mild or short-term anxiety. Fear of flying is considered a specific phobia, not generalised anxiety disorder, meaning Diazepam is no longer indicated for this purpose.
Fear of MRI & CT scans:
As a GP practice we do NOT prescribe sedatives for patients undergoing radiological procedures such as CT scans or MRI scans as it is deemed unsafe for the following reasons:
- Ineffective sedation: A 2mg dose of Diazepam is typically sub-therapeutic for most adults and not effectively sedate the patient and may cause agitation in certain individuals.
- Timing issues: Patients might take a sedative an hour before the procedure, only to find the procedure has been delayed, making the sedative timing less effective.
- Lack of GP expertise: GPs are not regularly trained or appraised in sedation techniques.
- Hospital Consultants role: Hospital consultants, who request and perform imaging, have the same prescribing capabilities as GPs. If a patient requires medication to proceed with an investigation, the consultant will be better positioned to prescribe it, either through the hospital pharmacy or a hospital prescription.
