What medication can I take for flight anxiety?
Only a doctor can prescribe medication for flight anxiety. The usual options are a short-acting benzodiazepine, a beta-blocker such as propranolol, or hydroxyzine. None of them treats the fear itself, and many doctors now advise against sedatives for flying. Exposure-based therapy has the stronger long-term evidence.
By FlightAnxiety.com editorial team · Updated · Each option compared in the table below, sources at the bottom.
What do doctors prescribe for fear of flying?
Doctors who prescribe for a flight usually choose between three types of medicine. Each works on a different part of the anxiety, and each has its own risks in the air.
| Type | Examples | What it does | Concerns on a flight | Evidence for flight anxiety |
|---|---|---|---|---|
| Benzodiazepines | Alprazolam (Xanax), lorazepam (Ativan), diazepam (Valium) | Sedates and lowers felt anxiety | Slower reactions in an emergency, deep sleep with little movement, dependence, dangerous with alcohol | One controlled study found it made the next flight harder (Wilhelm & Roth, 1997) |
| Beta-blockers | Propranolol | Dampens physical symptoms such as a racing heart and shaking | Not suitable for everyone, for example people with asthma. Does not change anxious thoughts | Little research on flight anxiety specifically |
| Prescription antihistamine | Hydroxyzine | Mild calming effect with drowsiness | Drowsiness; adds to alcohol and other sedatives | Little research on flight anxiety specifically |
| Daily anxiety medicine | SSRIs such as sertraline | Long-term treatment for anxiety disorders | Takes weeks to work, so it is not a flight-day option | Used for anxiety disorders in general, not tested for single flights |
| Over-the-counter sleep or travel aids | Diphenhydramine, dimenhydrinate (Dramamine) | Causes drowsiness; not an anxiety treatment | Same drowsiness and immobility concerns as sedatives | None for anxiety |
This table is general information, not a recommendation. Your doctor decides what is safe for you, based on your health and other medicines.
Do benzodiazepines help with fear of flying?
They can make one flight feel easier, but they do not reduce the fear over time. In a controlled study of people with flight phobia, alprazolam lowered how anxious people said they felt, yet raised their heart and breathing rate during the flight (Wilhelm & Roth, 1997).
On a second flight without the drug, the people who had taken alprazolam did worse than those who had taken a placebo. A likely reason is that the sedative stopped them from learning that the flight was safe. That learning is what makes gradual exposure work.
Why do many doctors now refuse to prescribe diazepam for flying?
Many UK GP practices stopped prescribing diazepam and similar sedatives for fear of flying because of safety risks on board (Old Catton Medical Practice, NHS; The Practice of Health, NHS Wales).
- Emergencies: sedation slows reactions and thinking, which matters if you need to leave the aircraft quickly.
- Blood clots: sedated sleep means less movement, which raises the risk of deep vein thrombosis, especially on flights over four hours.
- Dependence: benzodiazepines can cause dependence and withdrawal. In 2020 the FDA required a boxed warning on the whole drug class for abuse, dependence and withdrawal risks (FDA).
- Travel law: diazepam and similar drugs are controlled or restricted in some countries. Check the rules of your destination before you pack them.
US doctors still prescribe benzodiazepines for flying more often than UK GPs do. The same risks apply wherever you live.
Can I buy flight anxiety medication over the counter?
No over-the-counter medicine in the US is approved to treat anxiety. Sleep and motion-sickness products make you drowsy, but they do not reduce fear. They also bring the same drowsiness and immobility concerns as prescription sedatives.
For supplements such as magnesium, lavender oil or CBD, see our review of natural remedies for flight anxiety. Ask a pharmacist before you combine any product with prescription medicine.
Can I drink alcohol with anxiety medication on a plane?
No. Alcohol adds to the sedating effect of benzodiazepines, hydroxyzine and antihistamines, and the combination can slow breathing. Skip alcohol on any flight where you take a sedating medicine.
What should I ask my doctor?
Bring your flight details and these questions to the appointment:
- Is this medicine safe with my other medicines and health conditions?
- How will it affect my alertness during the flight and after landing?
- What is my blood clot risk on this flight, and what should I do about it?
- Is this medicine legal at my destination and on any stopover?
- Can you refer me to a therapist who offers CBT with exposure for specific phobias?
What works better than medication in the long run?
Exposure-based cognitive behavioral therapy has the strongest evidence for specific phobias, including fear of flying (NHS). It teaches your alarm system that flying is safe, so the fear shrinks with each flight.
To start today, use a breathing technique for the flight, then compare therapy, VR exposure and courses.
Flight anxiety medication FAQ
What medication can I take for flight anxiety?
Only a doctor can prescribe medication for flight anxiety. The options they may discuss are a short-acting benzodiazepine, a beta-blocker such as propranolol for physical symptoms, or hydroxyzine. Many doctors now advise against sedatives for flying, and exposure-based therapy has the stronger long-term evidence.
Is Xanax good for fear of flying?
Alprazolam (Xanax) can lower how anxious you feel during one flight, but it does not treat the fear. In a controlled study, flyers who took alprazolam felt calmer yet had a higher heart and breathing rate, and did worse on a later flight without it. It also slows reactions and carries an FDA boxed warning about dependence.
Why won't my doctor prescribe diazepam for flying?
Many UK GP practices stopped prescribing diazepam for fear of flying. They cite slower reactions in an emergency, deep sedated sleep that reduces movement and raises the risk of blood clots on long flights, and dependence. Diazepam is also restricted in some countries.
Can I buy flight anxiety medication over the counter?
No over-the-counter medicine in the US is approved to treat anxiety. Sleep and motion-sickness products such as diphenhydramine or dimenhydrinate cause drowsiness but do not treat fear, and they bring the same drowsiness and immobility concerns as sedatives. Check any product with a pharmacist before flying.
Can I drink alcohol with anxiety medication on a plane?
No. Alcohol adds to the sedating effect of benzodiazepines, hydroxyzine and antihistamines, and the combination can slow breathing. Avoid alcohol on any flight where you take a sedating medicine.
Sources
- Wilhelm & Roth (1997), Effects of alprazolam on flight phobics during exposure — Behaviour Research and Therapy
- FDA (2020), Boxed Warning updated to improve safe use of benzodiazepine drug class
- Old Catton Medical Practice (NHS), Tablets for fear of flying: why we don't prescribe them anymore
- The Practice of Health (NHS Wales), Diazepam and medication for flying
- NHS, Phobias
By the FlightAnxiety.com editorial team. Our AI-assisted editorial work summarises published research and medical guidance. We are not clinicians, and this page has not been independently clinically reviewed. It is educational and not medical advice. Never start, stop or change a medicine without your doctor. How we make this site.