Alprazolam for Flight Phobia? Short-term Relief with Long-term Consequences

Detalles: Publicado: 07 Diciembre 2023

What is Flight Phobia?

Flight phobia is a type of specific phobia characterized by an intense and irrational fear of flying. For some, it involves catastrophic thoughts, such as fearing a plane crash, while others experience physical symptoms like heart palpitations, excessive sweating, shortness of breath, and panic attacks. In some cases, this fear is part of a panic disorder with agoraphobia.

The most effective treatments include:

Cognitive-Behavioral Therapy (CBT): Especially using gradual exposure techniques.
Pharmacotherapy: The use of anti-anxiety medications like alprazolam.

The Study: Immediate and Delayed Effects of Alprazolam

Researchers at Stanford University recruited 28 women with flight phobia and divided them into two groups: one received 1 mg of alprazolam, while the other received a placebo. Both groups undertook two flights one week apart.

During the flights, the researchers measured:

Subjective anxiety levels using self-assessment scales.
Physical symptoms like heart palpitations and rapid breathing.
Physiological responses via heart rate and respiratory monitoring.

Results: What Did They Find?

First Flight: Immediate Relief

The group that took alprazolam reported significantly less subjective anxiety and fewer symptoms. However, their heart rate and breathing rate increased, indicating a paradoxical physiological stress response.

Second Flight: The Rebound Effect

One week later, without medication, the results were drastic:

71% of the alprazolam group experienced panic attacks compared to only 7% in the placebo group.
Heart rates rose further, reaching up to 123 bpm.
The placebo group experienced reduced anxiety, highlighting the benefits of exposure without medication.

Why Does Alprazolam Worsen Long-term Flight Phobia?

Interference with exposure therapy: The medication blocks the experience of anxiety, preventing the brain from learning that flying is safe.

Psychological dependence: People attribute their reduced anxiety to the medication rather than their own coping abilities.

Rebound effect: Once the medication is removed, anxiety intensifies, triggering catastrophic thoughts and panic.

Increased physiological response: Alprazolam deregulates the body’s autonomic stress responses under extreme conditions.

Implications for Treating Flight Phobia

This study offers key insights for clinicians and patients:

Exposure therapy without medication is more effective in the long run.
Alprazolam use should be carefully considered due to its potential to worsen anxiety.
Cognitive-behavioral therapy (CBT) remains the safest and most effective tool for treating flight phobia.

Parting Words

The study shows that while alprazolam may provide short-term relief, it is not a sustainable solution for overcoming flight phobia. Gradual exposure to flying, without medication, allows the brain to process and adapt to the fear naturally. The true solution lies not in a pill, but in building confidence and coping strategies to manage anxiety effectively.

Author: Based on the study by Frank H. Wilhelm and Walton T. Roth (Stanford University, 1997).

Author: Psicólogo José Álvarez