• 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.

Claustrophobia and MRI scans

• GPs will not issue prescriptions for sedating medications (such as diazepam) prior to MRI scans.
• 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, if sedation if required, this is more safely administered by the hospital team who can monitor for any complications.

• We understand that many people experience anxieties about flying, & it is common for patients to ask for sedative medication (such as diazepam) to help manage this.
• As a practice, we do not prescribe sedatives for fear of flying.
• Below, we explain why this decision is in place, based on patient safety, clinical guidance & legal considerations.

Why we do not prescribe sedatives for flying

Safety on board

• Sedatives slow reaction times, impair decision making & coordination. In the rare event of an in-flight emergency, this could put both the passenger & 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 more significant.
• Some people may experience paradoxical effects, such as agitation or aggression, rather than calm.

Guideline & clinical reasons

• Benzodiazepines (e.g. diazepam) are not 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, so these medicines are not indicated.

Other important considerations

• Combining sedatives with alcohol (often consumed by nervous flyers) increases the risk of complications.
• Importing or carrying sedative medication is illegal in some countries, which could cause problems when travelling abroad.
• Sedatives carry a risk of dependence &, with regular use, may be linked to cognitive side effects.
• GP indemnity generally only covers prescribing for use in the UK; use during travel abroad may not be covered.

What you can do instead

Fear of flying is common, & there are safer, evidence-based approaches to help manage it:

• Fear of flying courses, often run by airlines, which combine education about flying with anxiety management techniques.
• Cognitive behavioural therapy (CBT), which has good evidence for helping with specific phobias.
• Self-help strategies such as breathing exercises, distraction (music, reading, puzzles) & talking openly to cabin crew about your anxiety.

Below are some courses & resources you may find useful:

• EasyJet Fearless Flyer
• Flying Without Fear
• British Airways – Flying With Confidence

Guidance from the UK Civil Aviation Authority (CAA)

The CAA advises that sedative drugs are not recommended for fear of flying, for the same safety & health reasons outlined above.

They encourage passengers to consider therapeutic options, self-help techniques & to seek professional advice before flying.

If you feel your anxiety is severe or part of a wider mental health condition, we recommend discussing this with your GP to explore the most appropriate & safe support.