We are often contacted by patients asking for prescriptions of certain medications to help ease anxiety related to undergoing hospital investigations or procedures (such as MRI/CT scanning, elective operative or dental intervention).
We appreciate that some of these aforementioned procedures can be daunting or anxiety inducing and previously GPs might have prescribed benzodiazepines (diazepam), which have a sedative or anxiolytic effect. The current prescribing guidelines states that diazepam is licensed for use in general anxiety for short durations due to the addictive qualities which can cause increased dependence and tolerance to the medication.
Recent local LMC guidance suggests that these medications should NOT be prescribed by GPs for this indication due to reasons below:
1. Benzodiazepines (diazepam) once taken can cause sedation, amnesia and impaired motor or cognitive function. It can be difficult to assess how patients will respond if they have never been exposed to these historically. In certain individuals a smaller dose can have a sub-therapeutic effect, whilst in others a paradoxical response can occur resulting in increased agitation.
2. When administered it is taken in anticipation of the procedure, usually an hour before. If there are any delays in proceedings it can result in a sub-optimal response as the effects begin to wear off.
3. As GPs, we do not routinely prescribe sedative agents. Based on The Royal College of Radiologists guidance to undertake safe sedation for radiological procedures, it should be administered by a trained health professional who routinely prescribes sedation for this indication and who can monitor the patient for the duration of its effects.
4. The majority of scans which are requested or procedures undertaken are done so by hospital consultants who are practicing prescribers. If you are feeling particularly anxious about your upcoming procedure it would be best to discuss your concerns with the requesting clinician to explore all options.