Finding the Right Sedative: What Sedative is Good for Fear of Flying?

October 11, 2025 •

5 min read

Fear of flying, or aviophobia, affects an estimated 2.5% to 6.5% of the global population, but for those who experience it, the need for relief is very real. Many seek medication to manage their anxiety, leading to the question: What sedative is good for fear of flying? This guide explores the pharmacological options and emphasizes safer, non-medicinal alternatives for managing flight anxiety.

Quick Summary

Several medications, primarily benzodiazepines like Xanax and Ativan, can be prescribed for severe fear of flying, but they come with significant risks, including dependence and impaired judgment. Alternatives include beta-blockers, certain antihistamines, and melatonin, as well as highly effective non-pharmacological strategies like Cognitive Behavioral Therapy (CBT), relaxation techniques, and exposure therapy. Consulting a healthcare provider is essential to weigh options safely.

Key Points

Benzodiazepines carry significant risks: Fast-acting sedatives like Xanax and Ativan are potent but pose risks of dependence, impaired judgment, and rebound anxiety.
Diazepam is often not recommended: Many medical practices avoid prescribing Diazepam (Valium) for flight anxiety due to a higher risk of side effects, including impaired emergency response and blood clots.
Beta-blockers target physical symptoms: Medications like Propranolol can help with physical anxiety symptoms such as a rapid heart rate but do not address the psychological components of fear.
OTC options are milder and less proven: Over-the-counter options like melatonin and sedating antihistamines can promote sleepiness but are not targeted anti-anxiety treatments and have their own side effects.
Cognitive Behavioral Therapy (CBT) is highly effective long-term: For sustainable relief, therapy, including CBT and Exposure Therapy, addresses the root cause of aviophobia and offers lasting coping mechanisms without medication.
Consult a healthcare provider before taking any medication: It is crucial to discuss all options with a doctor to safely weigh the risks and benefits of both pharmacological and non-pharmacological approaches.

Understanding Medications for Flight Anxiety

For those with severe aviophobia, a healthcare provider might consider prescribing medication to help manage the symptoms. The most common pharmacological options fall into a few distinct categories, each with its own benefits and risks. It is crucial to understand that no medication is without side effects, and some carry significant safety concerns, especially in the context of air travel.

Benzodiazepines: The Most Prescribed Sedatives

Benzodiazepines, often called "benzos," are a class of sedative drugs that act as central nervous system depressants. They work by boosting the activity of gamma-aminobutyric acid (GABA), a calming chemical messenger in the brain. This can result in significant relaxation and reduced anxiety.

Alprazolam (Xanax): Known for its rapid onset of action, Xanax can provide quick relief for intense panic attacks. However, its effects are relatively short-lived, often wearing off within 4 to 6 hours. This can be a concern for longer flights, potentially leading to a rebound of anxiety mid-journey.
Lorazepam (Ativan): With a slightly longer duration of action (up to 8 hours), Ativan may be more suitable for longer flights. It takes a bit longer to take effect than Xanax but offers more sustained relief.
Diazepam (Valium): While once commonly prescribed, many medical groups now discourage or refuse to prescribe diazepam for fear of flying due to safety concerns. These include the potential for slowed reaction times in emergencies, increased risk of blood clots (especially on longer flights), and a potential for paradoxical agitation. It is a controlled substance with a risk of dependence.

Non-Benzodiazepine Prescription Alternatives

Some physicians may explore other prescription options with a different risk profile.

Beta-blockers (e.g., Propranolol): These medications are primarily used for heart conditions but can be prescribed off-label for anxiety, particularly to manage the physical symptoms. Beta-blockers help control physical manifestations of anxiety like rapid heartbeat, sweating, and tremors, but do not address the cognitive or emotional aspects of the fear.
Hydroxyzine: An antihistamine with anti-anxiety properties, hydroxyzine can be an alternative for those seeking a medication with a lower risk of dependence than benzodiazepines. It can be useful for managing anticipatory anxiety in the days leading up to a flight.

Over-the-Counter Options

For individuals with milder anxiety, some over-the-counter (OTC) options and supplements might offer some relief, though they are generally less potent than prescription drugs.

Melatonin: As a hormone that regulates sleep, melatonin may be helpful for inducing sleep on the plane. Some find its calming effects useful for managing anxiety, but its efficacy is anecdotal, and it is not a direct anti-anxiety medication.
Antihistamines (e.g., Diphenhydramine, Doxylamine): Common OTC sleep aids and allergy medications often contain sedating antihistamines that can cause drowsiness. While they might help you sleep, they can also lead to grogginess and a "hangover" effect upon landing.
Herbal Supplements (e.g., Valerian Root, Chamomile, Lavender): Certain herbal products are known for their calming properties. Valerian root is used as a mild tranquilizer, while chamomile and lavender have been used for centuries to promote relaxation. It is essential to consult a healthcare provider before using these, as they can interact with other medications.

Non-Pharmacological Strategies for Managing Aviophobia

Medication is not the only, or often the best, solution for fear of flying. Several behavioral and psychological strategies can be highly effective.

Cognitive Behavioral Therapy (CBT): CBT is a well-established method for addressing specific phobias like aviophobia. It helps individuals identify and challenge the irrational thoughts that fuel their fear. A therapist can provide strategies to manage anxious thoughts and behaviors.
Exposure Therapy: A form of CBT, exposure therapy gradually and safely exposes an individual to their fear. This can range from watching videos of planes to visiting an airport and eventually taking short flights. The goal is to desensitize the fear response over time.
Relaxation Techniques: Simple techniques such as deep breathing, mindfulness meditation, and progressive muscle relaxation can help calm the body and mind during periods of anxiety. These can be practiced before and during a flight to ground oneself.
Preparation and Distraction: Strategic planning can reduce stress. Booking direct flights, choosing a seat over the wings where turbulence is less noticeable, and having plenty of distractions like movies, books, or puzzles can help.

Comparison of Medications and Strategies for Flight Anxiety


Option	Type	Speed of Onset	Duration	Main Benefit	Risks & Considerations
Benzodiazepines (Xanax, Ativan)	Prescription	Fast (minutes)	Short-Medium (4-8 hours)	Rapid sedation for panic attacks	Dependency, impaired judgment, withdrawal symptoms, illegal in some countries, DVT risk
Beta-blockers (Propranolol)	Prescription	Medium	Medium	Manages physical symptoms (heart rate, tremors)	Does not address cognitive fear, prescription needed
Hydroxyzine	Prescription/Antihistamine	Medium-Slow	Long	Lower dependence risk than benzos	Drowsiness, potential for grogginess
OTC Antihistamines (Diphenhydramine)	Over-the-Counter	Medium	Medium-Long	Induces drowsiness, easy to obtain	Hangover effect, dry mouth, can impair judgment
Melatonin	Over-the-Counter	Medium-Slow	Medium-Long	Promotes sleepiness	Efficacy for anxiety is anecdotal, not a direct anxiolytic
Herbal Supplements	Over-the-Counter	Varies	Varies	Natural calming effects	Potential for drug interactions, inconsistent efficacy, quality control
Cognitive Behavioral Therapy (CBT)	Non-Pharmacological	Long-Term	Long-Term	Addresses root cause of fear	Requires time and commitment to therapy
Exposure Therapy	Non-Pharmacological	Long-Term	Long-Term	Desensitizes fear response	Can be intense, requires professional guidance

Conclusion

While prescription sedatives like benzodiazepines can provide rapid relief for severe flight anxiety, they are not without significant risks and are often considered a last resort by many medical professionals. Safer, long-term strategies like Cognitive Behavioral Therapy (CBT) and Exposure Therapy address the root cause of the fear, leading to more sustainable results. Before considering any medication, it is essential to have an open and honest conversation with a healthcare provider about your symptoms, medical history, and treatment goals. They can help you weigh the risks and benefits of all available options, including non-medicinal approaches, to create a plan that ensures a safer and more manageable travel experience.

Ultimately, the best sedative for fear of flying is not necessarily a pill, but a well-informed decision made in consultation with a medical professional, prioritizing safety and considering all available therapeutic options. The goal is not just to get through the flight but to overcome the fear for good. For more in-depth information and resources on managing anxiety disorders, including aviophobia, consider exploring resources from the Anxiety and Depression Association of America.

Frequently Asked Questions

Yes, but with caution and a prescription. Xanax (alprazolam) is a benzodiazepine that can provide rapid, short-term relief for flight anxiety. However, it carries risks of dependency, impaired judgment, and may wear off during a long flight, potentially causing a rebound of anxiety.

Many medical professionals no longer recommend Diazepam for fear of flying due to significant safety risks. These include slowed reaction times in an emergency, increased risk of deep vein thrombosis (DVT), and potential for paradoxical agitation.

Beta-blockers, such as Propranolol, are a non-addictive option that can be prescribed off-label for flight anxiety. They are effective at managing the physical symptoms like rapid heart rate and tremors, but do not affect the cognitive aspects of the fear.

There are no FDA-approved over-the-counter medications specifically for anxiety. Some people use sedating antihistamines or melatonin to induce drowsiness, but these are not direct treatments for anxiety and come with their own side effects, like grogginess.

CBT helps you address the root cause of your aviophobia by identifying and challenging the negative thought patterns associated with flying. It provides you with coping strategies and skills to manage anxiety long-term, reducing reliance on medication.

Combining alcohol and sedatives is extremely dangerous and should always be avoided. This mixture can lead to severe sedation, dangerous respiratory depression, and potentially life-threatening complications, especially at high altitudes.

Some herbal supplements like chamomile and valerian root have calming properties and may offer mild relief. However, their efficacy for anxiety is variable and their quality is not regulated. Always consult a doctor before using them, especially if you are taking other medications.