Prescribing for dental procedures
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 FP10D 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.
Prescribing for anxiety or claustrophobia during an MSI scan.
GPs will not issue prescriptions for sedating medications (such as diazepam) prior to MRI scans.
It’s estimated that every year, approximately two million MRI scans worldwide are not performed because of patients refusing to be scanned or terminating the scan early due to claustrophobia.
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, the NHS website suggests that mild sedatives are an option for people with severe MRI anxiety.
GPs are recommended to carefully consider the 2024 Royal College of Radiologists’ guidance: Sedation, analgesia and anaesthesia in radiology, third edition | The Royal College of Radiologists which states “Sedation and analgesia can effectively alleviate the pain, anxiety and psychological and physical distress of radiological procedures and is extensively used in routine clinical practice. Sedation and analgesia should be administered by a competent and well-trained sedation team and oversight provided by a sedation committee within the institution.”
There is also an emphasis on thorough pre-procedure assessment, planning and monitoring of the patient throughout the procedure.
This means that the GP is not the right person to prescribe these medications. If they are needed, then this should be discussed with the radiology team. The radiology team may also be able to offer other options such as the use of a less restrictive scanner.
Prescribing for flight anxiety
For the following reasons we have taken the decision not to provide Diazepam or similar drugs for flight anxiety, and instead suggest the links to aviation industry recommended flight anxiety courses at the end of the page.
- Diazepam in the UK is a Class C/Schedule IV controlled drug. It is a sedative, which means it makes you sleepy and more relaxed. If there is an emergency during the flight it may impair your ability to concentrate, follow instructions and react to the situation. This could have serious safety consequences for you and those around you.
- Sedative drugs can make you fall asleep, however when you do sleep it is an unnatural non-REM sleep. This means you won’t move around as much as during natural sleep. This can cause you to be at increased risk of developing a blood clot (DVT) in the leg or even the lung. Blood clots are very dangerous and can even prove fatal. This risk is even greater if your flight is greater than 4 hours.
- Whilst most people find benzodiazepines like diazepam sedating, a small number of people experience the opposite effect and may become aggressive. Benzodiazepines can also cause disinhibition and lead you to behave in a way that you would not normally. It can also paradoxically increase anxiety. This could impact on your safety as well as that of other passengers and could also get you into trouble with the law.
- According to the national prescribing guidelines that doctors follow (the British National Formulary, or BNF) benzodiazepines are not permitted to be prescribed in cases of phobia. Therefore, your doctor would be taking a significant legal risk by prescribing diazepam for fear of flying as it is going against these guidelines. Benzodiazepines are only licensed short term for a crisis in generalised anxiety. If this is the case, you should be getting proper care and support for your mental health and not going on a flight.
- Diazepam and similar drugs are illegal in a number of countries. They may be confiscated or you may find yourself in trouble with the police.
- Diazepam stays in your system for quite a while. Your driving may be impaired after your flight. If your job requires you to submit to random drug testing you may fail this having taken diazepam.
We appreciate that fear of flying is very real and very frightening. A much better approach is to tackle this properly with a Fear of Flying course run by the airlines. We have listed a number of these below.
Easy Jet: Fear of flying course | Fearless Flyer Tel 0203 8131644
British Airways: Fear of flying courses from British Airways™ | Flying With Confidence Tel 01252 793250
Virgin: flyingwithoutfear | Virgin Flying Without Fear