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  • Anti-Anxiett Meds

    This Is A Copy Of My Psychology Today Article At https://www.psychologytoday.com/blog...ion-and-flying

    Anti-anxiety medication to reduce flight anxiety backfires. 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 conditions 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 alcohol is 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.”
    At Anti-anxiety medication to reduce flight anxiety backfires. 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 conditions 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 alcohol is 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.”
    Using anti-anxiety medication to reduce flight anxiety backfires. 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.

  • #2
    I understand all this. But suppose you simply cannot get on the plane? My phobia clinic belives I may have the worst flying phobia they have seen. I have tried so many things to decrease it. I have xannax as a last resort to try ensure I can make my flight, after avoiding flying for 15 years.

    Comment


    • Castymiss
      Castymiss commented
      Editing a comment
      I am also the same way. I have NEVER flown. 61 years old and NEVER flown out of fear I will have a full blown panic attack. My friends want to go to Iceland this December. I don't know how I can get on that plane. I have panic disorder and it pops up only once in a while. On an elevator, high bridges, etc...My therapy is keeping 1mg of Xanaxs in my pocket just in case. I hardly ever use it. Maybe 2 times a year. I take 0.25mg. I need help to fly. I think of I can sit in a cockpit with the pilot that will help but no big commercial planes allow this. Well this is my story. A sad one. I take trains and cruises all over to Hawaii, Alaska, With a world cruise planned round trip to Florida. I live in Calif and will take the train to Florida to catch my cruise. UNLESS I can be helped haha.

  • #3
    I'd be interested to know what treatment your phobia clinic uses. Almost all of them use CBT, and CBT is very close to useless for fear of flying. In other words, what you phobia clinic is saying is, in my view, meaningless. If you want effective help, this is the place to get it.

    Comment


    • #4
      I am going to try avoid the medication, though if at the airport and unable to board, I will have to try it. My therapist used various techniques, mostly education about anxiety and also virtual reality, they also did exposure therapy but I was unable to take the short flight with him.

      Comment


      • #5
        It is considered unprofessional to criticize another therapist, but it is - as I see it - irresponsible if I don't advise you if you are being treated with fake treatment. VRET is junk. I know that because I was involved in the original VRET research study. It was done here in CT. They treated on group with VRET; a comparison group simply sat on a parked airplane for a while.

        Then, both groups flew. The people who sat on the parked airliner did better than the people treated with VRET. This clearly showed VRET to be a dismal failure. But there is big money invested in VRET, and the sponsors refused to recognize VRET failed as a treatment for fear of flying. So they lied. The claimed that the group who sat on the parked airplane had completed a "traditional fear of flying program" and that since the results of VRET we close to the results of the group they falsely claimed had done a traditional course, they said "VRET is a convenient alternative to a traditional fear of flying program."

        A traditional fear of flying program involves several days of lecture about how flying works, exposure to a parked airliner, relaxation exercise training, and one or more ACTUAL flights. Sitting on a parked airliner is NOT a traditional fear of flying course. It is not a fear of flying course at all!

        The company behind VRET promoted the failed VRET treatment as a viable option that a person could take without having to go to an airport, as VRET is done in a psychologist's office.

        I was outraged as this bald-faced lie, and wrote Barbara Rothberg, the lead psychologist at the company sponsoring VRET about this outright lie, and got a mealy-mouthed reply. At least she replied. But instead of facing the fact, the company continued promoting VRET as highly effective and a lot of psycholoigists - who should know how to recognize fake research - were taken in (or didn't care) and offer this bogus treatment.

        If I were you, I would demand a refund, and if they will not refund you, I'll do what I can to back you up. I hate fakes.

        Comment


        • Castymiss
          Castymiss commented
          Editing a comment
          Where can I find this type of experience? I am in Los Angeles. I want to sit on a plane and end up flying with other fearful flyers.

      • #6
        You miss the point. Sitting on a parked airplane is almost useless, and VRET is no better. Flying with other fearful fliers does not provide lasting help. Courses that provide that are a rip-off. That does not help you fly on your own. If you want effective help. go to https://www.fearofflying.com/relief/

        Comment

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