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Research on anti-anxiety meds and flying

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  • Research on anti-anxiety meds and flying

    Anti-anxiety medication to reduce flight anxietybackfires. The temporary — and generally inadequate — relief gained comes with a high long-term cost. Anti-anxiety medications prevent anxious fliers from getting used to flying. They increase the anxious flier's sensitivity to the plane’s noises and motions. They impact the person’s memory and ability to learn. They cause psychomotor impairment. And, they are addictive.

    According to research at the Stanford University School of Medicine, though the person taking anti-anxiety medication may feel more relaxed psychologically, there is increased arousal physiologically. “Alprazolam increases physiological activation under acute stress onditions and hinders therapeutic effects of exposure in flying phobia”

    In this research study, 28 anxious fliers took two flights. On the first flight, half received alprazolam (generic Xanax) and half received a placebo.

    Those taking alprazolam reported significantly reduced levels of anxiety compared with those taking a placebo during the first flight. However, their heart rate (114 bpm) and breathing rate (22.7 breaths/min) were much higher than in the group that had taken a placebo.

    On a second flight a week later without medication, 71 percent of those who had taken alprazolam on the first flight had significantly increased anxiety, an increased heart rate (123 bpm), a desire to leave the plane, and panic. Commenting on this research in article in Clinical Psychiatry News, Shanna Treworgy, Psy.D., of the Dartmouth Geisel Medical School, said that though there may be reduced anxiety in the moment, benzodiazepines cause increased long-term anxiety reactions. This, she reported, has been "documented in both animal and human studies.”

    An article in Clinical Psychiatry News says, "Widespread long-term use of benzodiazepines for anxiety remains a reality, despite guidelines that recommend against the practice.” Dominic Candido, who teaches psychiatry at the Dartmouth Geisel School of Medicine, says the use of benzodiazepines "significantly diminishes the effects" of treatment for anxiety. Short-term relief is, he says, "often at long-term detriment to the patient.”

    Taken as prescribed, anti-anxiety medication do not adequately relieve flight anxiety. During flight, when the prescribed dose fails to provide relief, an anxious flier — perhaps in a state of panic — is likely to take more and, perhaps, to combine it with alcohol. Combining anti-anxiety medication with alsoholis unsafe. A news article about the excessive in-flight use of Xanax by actress Winona Ryder is at this link.

    On the other hand, those who had taken a placebo on the first flight showed significant improvement. Having gained some degree of desensitization during the first flight, they now reported less anxiety.

    In an New York Times article on flight phobia, psychiatrist Richard A. Friedman, M.D. wrote, "If you think you can outsmart your phobia with anti-anxiety medications like Valium and Klonopin, forget about it; they might numb you during an acute panic attack, but they will not erase your phobia. In fact, they could get in the way of therapy because they impede new learning, which is the essence of curing phobias. To kick a travel phobia, you have to fight fire with fire; you have to tolerate some anxiety to get rid of it. No shortcuts.”

  • #2
    Thanks for sharing this information. if you don't mind, I'll share my own experience. I'd always struggled with taking any meds, or even having blood drawn at the doctor. I also hadn't flown much in my life - I'd backed off the plane as many times as I'd gotten through a flight. There's been a big personal cost for me.
    The time came when my family had a chance to go to Europe for two weeks, and work wanted to send me overseas for a project. I decided to face flying, but I was far from committed. And honestly, no one thought I was going to do it. I didn't blame them.
    I was desperate. I went to see a psychiatrist. He gave me prescriptions for Xanax and propranolol, and instructed me to try them a few days before flying. Even with the drugs, I was nervous as heck -- I had bad, bad anxiety. But I kept flying, even after those trips. And I cut back on the meds with each flight. It took 15 flights, but I finally got drug-free and able to sit back and enjoy takeoff and the flight.
    Drugs are not the answer. I completely agree. At a full dose of my Xanax, I didn't remember most of my short flight a week later. It didn't fix anything; it just turned down the panic. Plus, I didn't like the memory loss.
    But drugs eased me into flying. Drugs made something wildly impossible possible. I had to still do the hard work, but they got me started.
    thanks again for everything that you do.


    • #3
      I feel similar to Rodemo who said drugs, "made something wildly impossible possible." Four years ago, when I hadn't flown in over twenty-five years I was able to get on a plane because of the emotional support of this site, and research and because of medication.


      • #4
        I feel the same, SOAR helped me immensely (thank you Captain Bunn and your team), but if it weren't for anti-anxiety medication, I would not be brave enough to step on the airplane without feeling like running off.


        • #5
          Though meds may give you courage to get on the plane, it is because you trust them. Each time you fly using meds, your sensitivity to the noises and the motions increases. At some point, the sensitivity will be so great that the meds do nothing at all. Plus, in order to keep your imagination from taking over and making you believe something awful is about to happen, you need your mind to be totally clear - not dulled by meds.

          So, what do you do? Each time your fly, still believing you need the meds, cut back on the dose. Keep cutting back until you take a flight with zero meds. On that flight you will fly better than every before. Then - and only then - will you realize that all the time you believed the meds were helping, tthe meds had been making the problem worse all along.