If the thought of boarding a plane fills you with dread, you are not alone. A fear of flying can range from anxiety in the days before a journey to intense panic when thinking about getting on the plane. For some people, the fear becomes strong enough that they avoid flying altogether.
This can understandably lead people to look into fear of flying medication. Some medicines may reduce particular symptoms of anxiety, but this is different from changing the fear, avoidance and predictions that keep a flying phobia going. Medication is also not automatically suitable for everyone.
In this blog, we look at the different types of medication people may ask about, what their limitations are, and how medication differs from CBT for a flying phobia.
For a broader overview of how phobias develop and what can keep them going, see our guide to understanding phobias.
Medication may reduce some anxiety symptoms temporarily, but it does not directly change the fear, avoidance and threat predictions that maintain a flying phobia.
Medication is not automatically suitable for fear of flying and should only be considered after discussion with a GP or another qualified prescriber.
Sedating medication can have side effects and safety implications, including reduced alertness, slower reactions and possible dependence.
CBT focuses on understanding what makes flying feel dangerous and gradually changing the thoughts and behaviours that keep the fear going.
Exposure work in CBT is planned and paced rather than forcing someone to take a flight before they are ready.
The most suitable approach depends on the person’s symptoms, wider health, current medication and whether the fear is part of another anxiety difficulty.
People often look for flight anxiety medication because they want something that could make a particular journey feel more manageable. Whether medication is appropriate, however, depends on the symptoms someone experiences and their wider circumstances.
It can help to think first about what the medication is intended to change. Some people are particularly troubled by physical symptoms such as shaking, sweating or a racing heart. Others experience anxiety more widely, with flying being one of several situations that cause difficulty.
This distinction matters because reducing a symptom temporarily is different from changing the thoughts, avoidance and safety behaviours that keep a phobia going.
If you are considering anxiety medication for flying, a GP or another qualified prescriber can take account of your medical history, other medication, previous reactions and whether the fear of flying forms part of a wider anxiety difficulty.
Medication should not be started, stopped or changed specifically for a flight without appropriate medical advice.
When researching flying anxiety medication, you may come across several different types of medicine. They have different purposes and limitations, and being used for anxiety does not automatically mean that a medicine is suitable for a fear of flying.
Beta blockers such as propranolol can reduce some of the physical symptoms associated with anxiety. The NHS information on propranolol explains that it can help with physical symptoms such as sweating and shaking.
For someone whose anxiety involves strong physical sensations, this may be something a prescriber considers. However, reducing those sensations does not necessarily change the person’s prediction that flying is dangerous or reduce the avoidance that has developed around it.
Beta blockers are not suitable for everyone, so their use needs to be considered individually by a qualified prescriber.
Some people ask about benzodiazepines such as diazepam because of their calming and sedating effects.
However, this type of medication also has important limitations. The NHS information on diazepam explains that it can cause drowsiness and reduced alertness, while longer-term use can lead to dependence and withdrawal symptoms.
Whether a benzodiazepine is appropriate for an individual is therefore something to discuss with the clinician responsible for their care rather than something that can be recommended generally for flying anxiety.
Antidepressants such as SSRIs and SNRIs are used for a number of mental health difficulties, including some anxiety disorders and phobias.
Their role is different from taking medication simply to manage an individual flight. If someone’s fear of flying forms part of a broader or more persistent anxiety problem, a prescriber may consider whether this type of medication has a role within their wider treatment.
Having a flying phobia alone does not mean that antidepressant medication will necessarily be appropriate. The potential benefits, limitations and side effects need to be considered for the individual.
Flying phobia, also called aviophobia, is an intense and persistent fear of flying. It can range from mild unease to full-blown panic, and it often leads to significant distress or avoidance of air travel. If panic symptoms are part of your experience, our cognitive therapy for panic disorder service may also be relevant.
For some people, the anxiety starts days or even weeks before the flight. It might involve worrying about turbulence, being trapped, or not being able to escape in an emergency. These fears can be triggered by previous negative experiences, such as a turbulent flight, or by broader anxiety issues like claustrophobia or a fear of heights.
Flying phobia is often linked to the fight-or-flight response, a natural survival mechanism that prepares the body to either fight a threat or escape from it. The problem is that this response can become overactive, leading to extreme anxiety even in situations where no real danger exists.
CBT for flying phobia focuses on understanding what makes flying feel dangerous and the thoughts and behaviours that can keep that fear going. Rather than simply trying to remove anxiety, therapy looks at the person’s individual predictions and what they do when the fear appears.
If you are wondering about the length of therapy and what longer-term CBT actually means, our article on whether CBT is a long-term therapy explains this in more detail.
This involves identifying and examining the fearful predictions that make flying feel dangerous. Someone might predict that the plane will crash, that they will lose control or that a panic attack will become unbearable.
If physical panic symptoms are part of the fear, our article on whether a panic attack can cause you to pass out explains what happens in the body during panic.
Exposure involves gradually approaching feared situations in a planned way rather than continuing to avoid them. Depending on the person, this might begin with relatively manageable situations before progressing towards more difficult parts of flying.
The aim is not to force someone through the highest level of fear. It is to create opportunities for new learning about the situation and the person’s ability to cope.
Behavioural experiments can be used to test specific predictions. For example, someone might explore whether experiencing turbulence really means that the aircraft is unsafe, or whether feeling anxious inevitably leads to losing control.
CBT uses these experiences to help the person develop a different understanding of the threat rather than simply being told that their fear is irrational.
Medication and CBT work in different ways, so it can be misleading to think of them as two versions of the same treatment.
Medication may reduce particular symptoms for some people. For example, a medicine might affect some of the physical sensations associated with anxiety. This does not necessarily change the person’s belief that flying is dangerous or the avoidance and safety behaviours that have developed around the fear.
CBT focuses more directly on these maintaining patterns. Someone may predict that turbulence means the plane is unsafe, worry that panic will become uncontrollable or believe they would be unable to cope with feeling trapped. They may then avoid flights, repeatedly seek reassurance or closely monitor their body for signs of anxiety.
Therapy helps the person understand these patterns and gradually test the predictions that continue to make flying feel threatening.
Medication may still have an appropriate role for some people, particularly where other anxiety difficulties are present. This needs to be considered individually rather than assuming that combining medication and CBT is routinely the best approach.
Are you struggling with flying phobia?
We help with flying phobia using evidence-based CBT in Bristol and online across the UK.
So, is fear of flying medication the right option? There is no single answer that applies to everyone.
Medication may reduce certain symptoms for some people, but its suitability depends on the individual, the symptoms they experience and their wider physical and mental health. A qualified prescriber can help determine whether medication has an appropriate role.
If the main difficulty is a persistent flying phobia, CBT focuses on the thoughts, predictions and behaviours that keep the fear going. Our article on the cognitive characteristics of phobias explains some of these thinking patterns in more detail.
If fear of flying is restricting your travel or affecting other parts of your life, you can also learn more about how we use CBT for specific phobias in Bristol and online.
Medication is not routinely the first treatment for a specific phobia. A GP or another qualified prescriber would need to consider your individual symptoms, medical history, other medication and the risks and benefits before deciding whether any medicine is suitable.
Some people ask for diazepam or a similar sedative, but many UK practices do not prescribe benzodiazepines for fear of flying because of concerns about sedation, impaired reactions, dependence and their suitability for phobias. Any decision must be made by the prescriber responsible for your care.
Beta blockers may reduce certain physical symptoms of anxiety for some people, but they do not address the fearful predictions or avoidance that maintain a phobia. They are not suitable for everyone, so their use should be discussed with a qualified prescriber.
Medication may reduce symptoms temporarily, but it does not usually provide the new learning needed to change a phobia. The fear may return on a later flight if the underlying predictions and avoidance patterns have not been addressed.
CBT helps identify what you predict will happen, how you respond to anxiety and which safety behaviours or avoidance patterns keep the fear active. Therapy can then use carefully planned cognitive and behavioural work, including supported exposure, to build a different understanding of flying.
This page is for general information and education. It is not personalised advice, diagnosis, or a substitute for professional assessment.
NOSA CBT offers evidence-based therapy for OCD, hoarding help, phobias, health anxiety, social anxiety, PTSD, panic disorder, and generalised anxiety disorder. We also provide a specialist OCD clinic, professional CBT supervision training, and CBT training and teaching for mental health professionals.
Get in touch today to find out how we can help.
