Sedatives when Flying

[matt_baked]

I went to my GP today to request some Lorazepam for a flight I have on Saturday. I have been prescribed it 3 times previously. Diazepam did not work, Lorazepam (around 2.5mg per flight) was around the correct dosage to rid me of any symptoms. I've travelled to Egypt on this dosage with no problems

Today I was told by the doctor that the guidelines have changed recently and that they have been advised to no longer prescribe sedatives for flights. GP said he was going to follow their advice - and as a result has prescribed me some Propranolol 10MG tablets, 1 for the way there & one for the way back

I am of course really worried now. I have read Propranolol 10mg is a low dose. This doesn't fill me with confidence, Diazepam at relatively high dosages did not work and I believe 2.5mg of Lorazepam is quite a lot too. I was told to take the Lorazepam (1mg tabs) in halves.. and doing this I found 2.5mg was the correct dosage

Has anyone else heard about these guidelines? Do you think it is worth seeing another GP? (Is this even possible?) Does anyone have any experience with Propranol?

I'm not really sure what to do now.

Thank you x

[MyNameIsTerry]

Hi and welcome to NMP :welcome:

Lorazepam is only licenced for severe anxiety but may also be used for panic disorder (unlicensed).

Given your GP advised you to split the normal starting dose up it sounds more like he/she was doing this "off label" because I would assume that severe anxiety would prevent someone even booking a flight let alone using a stategyu such as this to calm it down enough to be able to fly. Given the Diazepam wasn't working for you, maybe your GP made a personal decision to try Lorazepam this way to help you.

Sadly, Lorazepam was never for this and maybe the NHS have issued guidance to cut down on GP's misprescribing Benzo's?

The guidance not to use them in mild/moderate and only in severe has been around since 1988. So, I would suggest that the NHS have been tightening up on GP's doing something they know they shouldn't be.

[matt_baked]

I have panic disorder. It can be quite extreme/severe. I have improved a lot but my worst case scenario is a flight/travelling long distance in a social environment where I have no escape.

I have seen various GP's who have prescribed me the Lorazepam as it works & the Diazepam didn't. As it stands, I don't think I'll be able to make my flight Saturday.

What shall I do?

[MyNameIsTerry]

Hi Matt,

Its good to hear you have improved a lot.

Its tricky because it looks like they shouldn't have been giving it out. I guess it depends on whether they classify you as severe, if not that might be why they are no longer doing it? Could you try one of those other GP's?

Beyond that, I'm not sure. I can say I've seen GP's say "we have been told not to use this anymore" about Pregabalin which has turned out to be nonsense so it could just be about costs or the fact he/she has realised they shouldn't be doing it and are blagging?

[MyNameIsTerry]

In case this comes up again, I found this by chance:

http://www.dorsetccg.nhs.uk/Downloads/aboutus/medicines-management/Useful%20Resources/Benzodiazepines%20Support%20Pack%20Mar14.pdf

Lorazepam 1mg (half or one) for aeroplane phobia (or free use
of other benzodiazepines)

This is dated March 2014. You could look around for other local trusts and you might find a more recent document. Then ask your GP when things changed and if he doesn't give a date after this, you know if isn't being truthful.

[Davit]

This is why people hoard.