From the Guidelines
For flight anxiety, Midazolam is not typically recommended due to its potent sedative effects and potential for respiratory depression, instead, medications like Alprazolam (Xanax) or Lorazepam (Ativan) are often preferred. When considering benzodiazepines for flight anxiety, it's crucial to weigh the benefits against the risks, including potential for dependence and impaired cognitive function 1.
Key Considerations
- The choice of benzodiazepine should be based on the individual's medical history, the specific circumstances of the flight, and the potential for drug interactions.
- Alprazolam (Xanax) is often recommended due to its rapid onset of action and relatively short duration, with a typical dose ranging from 0.25mg to 0.5mg taken 30-60 minutes before the flight 1.
- Lorazepam (Ativan) is another option, typically prescribed at 0.5-1mg doses, and is known for its anxiolytic effects without significant sedation in lower doses.
- Non-medication approaches such as deep breathing exercises, distraction techniques, and cognitive behavioral therapy can also be effective complementary strategies for managing flight anxiety.
Important Safety Information
- Benzodiazepines can cause drowsiness, impaired coordination, and have potential for dependence, thus they should be used sparingly for specific anxiety-provoking situations like flights rather than as regular treatment.
- It is essential to consult with a healthcare provider before using any benzodiazepine, especially to discuss the risks and benefits and to determine the most appropriate medication and dosage for individual needs.
Additional Strategies
- Combining medication with non-pharmacological interventions may offer the best approach for managing flight anxiety, allowing for a more comprehensive treatment plan that addresses both the physical and psychological aspects of anxiety.
From the FDA Drug Label
Anxiety Disorders Alprazolam tablets are indicated for the management of anxiety disorder Panic Disorder Alprazolam tablets are also indicated for the treatment of panic disorder, with or without agoraphobia
Alprazolam is recommended for the management of anxiety disorder and panic disorder, which may be associated with flight anxiety. However, the label does not explicitly mention flight anxiety as an indication.
- The drug is indicated for anxiety disorder and panic disorder.
- Flight anxiety may be a type of anxiety disorder or panic disorder, but this is not explicitly stated in the label. 2
From the Research
Benzodiazepines for Flight Anxiety
- There is no specific benzodiazepine recommended for flight anxiety based on the provided studies.
- A study from 1997 3 found that alprazolam reduced self-reported anxiety and symptoms in individuals with flying phobia, but it also increased physiological activation and hindered therapeutic effects of exposure in the long run.
- Other studies focus on the general use of benzodiazepines for anxiety disorders 4, cognitive-behavioral therapy for anxiety disorders 5, and the discontinuation of benzodiazepines in patients with anxiety disorders 6, 7.
- These studies suggest that cognitive-behavioral therapy (CBT) can be an effective treatment option for anxiety disorders and may assist in the discontinuation of benzodiazepines, but they do not specifically address the use of benzodiazepines for flight anxiety.
- Overall, the provided evidence does not support the recommendation of a specific benzodiazepine for flight anxiety, and further research is needed to determine the most effective treatment options for this condition.