From the Guidelines
Benzodiazepines like alprazolam (Xanax) or diazepam (Valium) are commonly prescribed for aviophobia (fear of flying), but the most effective treatment is in vivo exposure, specifically virtual reality exposure treatment, as it has been found to be effective for flying phobia. The typical dosage for benzodiazepines is 0.25-0.5 mg of alprazolam or 2-5 mg of diazepam, taken 30-60 minutes before a flight, as they work quickly to reduce anxiety by enhancing the effect of GABA, a calming neurotransmitter in the brain 1. For longer-term management, selective serotonin reuptake inhibitors (SSRIs) like sertraline (Zoloft) or fluoxetine (Prozac) may be prescribed, but the evidence for their effectiveness in treating aviophobia is limited. Some key points to consider when treating aviophobia include:
- Virtual reality exposure treatment has been found to be effective for flying phobia, as indicated by a review of specific phobia treatment options 1
- In vivo exposure is an effective form of treatment for most types of specific phobia, including aviophobia, with treatment gains maintained for 6 months to 1 year 1
- Combining medication with cognitive-behavioral therapy or exposure therapy often provides the best results for managing aviophobia long-term
- Beta-blockers such as propranolol (10-40 mg) can help manage physical symptoms of anxiety like rapid heartbeat and trembling, but their effectiveness in treating aviophobia is not well established. It's essential to consult a healthcare provider before using any of these medications, as they can have side effects and interactions.
From the Research
Medications for Aviophobia
- Benzodiazepines are commonly used to treat anxiety disorders, including aviophobia (fear of flying) 2, 3, 4
- Specific benzodiazepines used for anxiety disorders include diazepam, alprazolam, temazepam, loprazolam, and lormetazepam 2
- Benzodiazepines can be effective in reducing anxiety symptoms, but long-term use can lead to dependence, tolerance, and withdrawal effects 2, 3, 5
- As-needed use of benzodiazepines is a common practice, but it may be associated with increased patient preference for benzodiazepines, continued use, and greater impairment on cognitive factors associated with positive long-term anxiety management 5
Considerations for Treatment
- Benzodiazepines should be used in conjunction with other measures, such as psychological treatments and antidepressants, for optimal treatment of anxiety disorders 2, 4
- Clinicians should be mindful of patterns and risk factors leading to long-term use of benzodiazepines in patients with anxiety disorders, including age, comorbid physical illness, and concurrent use of other medications 3
- Alternative treatments, such as cognitive-behavioral therapy and selective serotonin reuptake inhibitors (SSRIs), may be effective for treating aviophobia and should be considered as part of a comprehensive treatment plan 4