Surrey Lodge Group Practice does not prescribe benzodiazepines or other sedative/hypnotic medications (including but not limited to diazepam, temazepam, lorazepam, or zopiclone) for the sole purpose of managing anxiety related to:
- Medical imaging procedures (MRI, CT scans, etc.)
- Air travel (fear of flying)
- Other situational anxieties not constituting a diagnosed medical condition
Rationale and Supporting Guidelines
1. British National Formulary (BNF) Guidance
The BNF states that benzodiazepines are indicated for short-term relief of severe anxiety only when it is disabling or causing unacceptable distress. The guidance specifically cautions against routine use for everyday stresses and emphasises the risk of dependence, even with short-term use.
Hypnotics and anxiolytics | Treatment summaries | BNF | NICE
2. MHRA and Civil Aviation Authority Position
The Medicines and Healthcare products Regulatory Agency (MHRA) and Civil Aviation Authority have issued warnings that:
- Benzodiazepines can impair cognitive function and reaction times for 24+ hours
- At altitude, sedative effects may be unpredictably enhanced
- Use during flight may increase risk of respiratory depression and venous thromboembolism
- Patients may experience disinhibition leading to dangerous behaviour
Alternative approaches
We recommend the following evidence-based resources for patients to peruse:
For Medical Scans
- NHS Guide to Coping with an MRI Scan: https://www.nhs.uk/conditions/mri-scan/
- Anxiety UK MRI Anxiety Support: https://www.anxietyuk.org.uk/
- Mind Charity – Coping with Claustrophobia: https://www.mind.org.uk/information-support/types-of-mental-health-problems/phobias/
- Relaxation audio tracks and apps (Headspace, Calm, NHS-recommended mindfulness apps)
For Fear of Flying
- British Airways Flying with Confidence: www.flyingwithconfidence.com/
- Virgin Atlantic Flying Without Fear: https://flywithoutfear.co.uk/
- easyJet Fearless Flyer Course: www.easyjet.com/en/help/fearless-flyer
- Anxiety UK Aviation Anxiety Programme: www.anxietyuk.org.uk/
- NHS Every Mind Matters – Fear of Flying: www.nhs.uk/every-mind-matters/mental-wellbeing-tips/self-help-cbt-techniques/
Patient information
Patients requesting sedation for situational anxiety will be:
- Provided with this policy explanation
- Offered information about evidence-based alternatives
- Supported with appropriate referrals where clinical anxiety disorder is suspected
- Encouraged to discuss concerns with imaging centres or airlines, who may have their own support services