What medication is used to calm you down before flying? A Guide to Prescription and OTC Options

According to the American Psychological Association, fear of flying affects up to 25% of the population. For those with severe anxiety, knowing what medication is used to calm you down before flying can be crucial for a smoother travel experience, but it's vital to consult a healthcare provider first to discuss the right approach for your specific needs.

Quick Summary

Several types of medication can alleviate anxiety before flying, from fast-acting prescription benzodiazepines to milder over-the-counter options like antihistamines or herbal supplements. These options address either the physical or psychological symptoms of anxiety, but it is essential to consider the potential side effects and interactions before use.

Key Points

• Prescription benzodiazepines: Fast-acting medications like Xanax and Ativan are highly effective for severe flight anxiety but carry risks of dependence and impaired coordination.

• Prescription beta-blockers: Medications like propranolol can manage physical symptoms of anxiety, such as rapid heart rate, without causing sedation.

• Prescription antihistamines: Hydroxyzine offers a sedative effect with a lower risk of dependence than benzodiazepines and can be used for anticipatory anxiety.

• OTC Options: Over-the-counter products like melatonin and dimenhydrinate (Dramamine) can help with mild anxiety or sleep issues.

• Safety Precautions: Always consult a doctor before taking any medication, test it at home first, and never combine anti-anxiety medication with alcohol.

• Therapy Alternatives: Non-drug options like cognitive behavioral therapy (CBT) and relaxation techniques provide long-term strategies for managing fear of flying.

For many, the thought of flying triggers intense anxiety, ranging from mild jitters to full-blown panic attacks. While therapeutic approaches like cognitive-behavioral therapy (CBT) and exposure therapy are long-term solutions, short-term pharmacological interventions can offer significant relief when facing a flight. These medications can be broadly categorized into prescription and over-the-counter (OTC) options, each with distinct mechanisms of action, benefits, and risks.

Prescription Medications for Flight Anxiety

Prescription medications are often recommended for severe or situational anxiety, as they offer more potent and targeted relief than OTC products. These drugs must be prescribed by a healthcare provider, who will determine the appropriate dosage and timing for your trip.

Benzodiazepines

Benzodiazepines, often referred to as 'benzos,' are central nervous system depressants that enhance the effect of the neurotransmitter GABA, which promotes relaxation and sedation. They are fast-acting, making them particularly useful for managing acute anxiety right before or during a flight.

• Common Examples: Alprazolam (Xanax), Lorazepam (Ativan), Diazepam (Valium), and Clonazepam (Klonopin).
• Pros: Rapid onset of action, highly effective for panic symptoms, and can induce sleep.
• Cons: High potential for dependence, can cause drowsiness and impaired judgment, and should not be mixed with alcohol. They are generally prescribed for short-term, as-needed use.

Beta-Blockers

Beta-blockers, such as propranolol, are primarily used to treat heart-related conditions but are also prescribed off-label for anxiety. Instead of affecting the central nervous system, they block the physical symptoms of anxiety caused by adrenaline, such as a rapid heart rate, sweating, and trembling.

• Common Examples: Propranolol.
• Pros: Does not cause sedation or alter cognitive function, and has a lower risk of dependence compared to benzodiazepines.
• Cons: Only addresses the physical symptoms, not the underlying psychological fear or worry.

Antihistamines

Certain antihistamines possess sedative properties that can help reduce anxiety. These are a less potent alternative to benzodiazepines and carry fewer long-term risks.

• Common Examples: Hydroxyzine (Vistaril, Atarax).
• Pros: Carries a lower risk of dependence and can be effective for anticipatory anxiety building up days before a flight.
• Cons: Can cause drowsiness and confusion.

Over-the-Counter (OTC) Options

For those with milder anxiety or a preference for non-prescription aids, several OTC options are available. The efficacy of these varies, and it's always best to discuss them with a healthcare provider first, especially if you take other medications.

• Dimenhydrinate (Dramamine): Primarily used for motion sickness, it also has a sedative effect that can help calm nerves.
• Melatonin: This natural supplement helps regulate sleep-wake cycles and can promote sleepiness on overnight flights.
• Herbal Remedies: Some people find relief with herbal products like chamomile, valerian root, or passionflower, known for their calming effects. The efficacy and quality can vary significantly.
• CBD Products: Cannabidiol (CBD) is also used by some for calming effects, but its effectiveness is largely anecdotal, and product quality is not always regulated.

Comparison Table: Prescription vs. OTC Medications

Feature	Benzodiazepines (Prescription)	Beta-Blockers (Prescription)	OTC Options (e.g., Antihistamines, Melatonin)
Speed of Action	Fast (minutes)	Moderate (around an hour)	Varies; Antihistamines are moderate, supplements can take longer
Primary Effect	Sedation, muscle relaxation, reduced panic	Blocks physical symptoms (tremors, palpitations)	Mild sedation, relaxation
Risks	High risk of dependence, withdrawal, impaired coordination	Dizziness, sleepiness; potential side effects for those with heart conditions	Lower risk; potential for drowsiness, varying efficacy
Mixing with Alcohol	Extremely Dangerous	Not recommended; consult your doctor	Should be avoided, especially with sedative OTCs
Focus	Treats both physical and mental anxiety	Focuses on physical symptoms only	Focuses on mild relaxation or sleepiness

Key Considerations Before Taking Medication

Before using any medication for flight anxiety, it's essential to plan and consider several factors to ensure your safety and effectiveness. A crucial first step is to discuss your concerns with a healthcare professional to determine if medication is an appropriate option for you.

1. Test Medications at Home: Always try a new medication well before your flight to see how your body reacts to it. You need to understand the potential side effects, such as drowsiness or dizziness, before you're in an enclosed cabin at 30,000 feet.
2. Avoid Alcohol: Combining any anti-anxiety medication with alcohol is extremely dangerous. It can intensify sedative effects, impair judgment, and increase the risk of serious complications like respiratory distress.
3. Understand International Regulations: Some prescription medications, especially controlled substances like benzodiazepines, may be illegal or require specific documentation to bring into certain countries. Research your destination's rules to avoid legal trouble.
4. Consider Non-Pharmacological Alternatives: For many people, strategies like deep breathing exercises, mindfulness, or listening to calming music can be effective. Addressing the root cause of the fear with therapy is also a powerful option.

Conclusion: Navigating Anxiety with Caution

For those with significant flight anxiety, medication can be a helpful tool to make air travel manageable. Prescription options like benzodiazepines offer powerful, fast-acting relief but come with notable risks like dependence and impaired judgment. Milder, over-the-counter remedies provide alternatives for less severe anxiety. Regardless of the choice, a comprehensive approach involving consultation with a healthcare provider and a focus on safety is paramount. Combining medication with non-pharmacological techniques like relaxation exercises can provide a more holistic and effective strategy for overcoming a fear of flying and ensuring a smoother journey. Consult a healthcare professional to discuss all your options and create a travel plan that suits your needs. For those interested in exploring cognitive and behavioral strategies, information can be found at resources like HelpGuide's section on anxiety management.

The Role of Lifestyle and Therapeutic Support

In addition to medication, a holistic approach can significantly improve flight anxiety. Cognitive Behavioral Therapy (CBT) helps reframe negative thoughts about flying, while exposure therapy can gradually desensitize you to the experience. Leading up to the flight, maintaining a regular sleep schedule, exercising, and avoiding caffeine or stimulants can prepare your body and mind for the trip. During the flight, practices like mindful breathing, using noise-canceling headphones, and engaging in distracting activities can help maintain a calm state.

Frequently Asked Questions

What is the best medication for severe flight anxiety?

For severe flight anxiety, a doctor may prescribe a fast-acting benzodiazepine like Xanax (alprazolam) or Ativan (lorazepam). These medications work quickly to relieve panic symptoms but carry risks of dependence and impaired judgment, so they are typically only used for short-term, situational relief.

Is it safe to mix anti-anxiety medication with alcohol before a flight?

No, it is extremely dangerous to combine anti-anxiety medication with alcohol. This combination can significantly enhance the sedative effects, leading to over-sedation, impaired coordination, and breathing problems, which can be life-threatening.

Can I take over-the-counter medication to calm myself down?

Yes, for mild anxiety, some people use over-the-counter options. Antihistamines like dimenhydrinate (Dramamine) have sedative effects, and natural supplements like melatonin can promote sleepiness. However, always consult a healthcare provider first, especially if you have other medical conditions or take other medications.

How do beta-blockers help with fear of flying?

Beta-blockers like propranolol work by blocking the physical symptoms of anxiety, such as a racing heart, trembling, and sweating. They do not affect the psychological aspects of anxiety, like worry, and are a good option for those who want to manage physical symptoms without sedation.

What should I know before taking medication for the first time before a flight?

You should always test a new medication at home before your flight to see how you react. This helps you understand any potential side effects, such as drowsiness or dizziness, and ensures there are no unpredictable reactions when you are in the air.

Are there non-medication alternatives for managing flight anxiety?

Yes, several non-medication strategies can be very effective. These include relaxation techniques like deep breathing and visualization, seeking professional help through cognitive behavioral therapy (CBT), or enrolling in a fear-of-flying course.

Do I need a prescription to get anti-anxiety medication for flying?

Stronger, more potent anti-anxiety medications like benzodiazepines and beta-blockers require a doctor's prescription. Milder options like antihistamines or herbal supplements are available over-the-counter, but a consultation with a healthcare provider is still recommended to ensure safety and effectiveness.

Can taking medication for flying anxiety cause long-term problems?

Long-term or frequent use of certain medications, particularly benzodiazepines, can lead to dependence and make anxiety worse in the long run. These drugs are typically intended for short-term use during a crisis, not as a permanent solution.