The most common option for MRI anxiety is a prescription anti-anxiety tablet taken one to two hours before your scan. For mild nerves, over-the-counter antihistamines or simple breathing techniques may be enough. The right choice depends on how severe your anxiety is and whether you have someone who can drive you home afterward.
Prescription Anti-Anxiety Medication
For moderate to severe claustrophobia, a short-acting benzodiazepine is the standard medical approach. The University of Wisconsin Department of Radiology, for example, recommends lorazepam (brand name Ativan): one 1 mg tablet taken one to two hours before the appointment, with a second tablet brought along in case you’re still anxious right before entering the scanner. Other commonly prescribed options include diazepam (Valium) and alprazolam (Xanax), all of which work by slowing nervous system activity so you feel calm but stay awake and responsive.
This level of sedation is called “conscious sedation.” You can follow instructions, hold still, and breathe normally during the scan, but your anxiety is significantly dulled. Success rates for completing MRI exams under conscious sedation are high, and for most adults it’s all that’s needed.
The important caveat: you will not be able to drive yourself home. Guidelines from the American Society of Anesthesiologists require that you be discharged in the presence of a responsible adult, and most facilities advise against driving, operating machinery, or making major decisions for 24 hours after taking a benzodiazepine. Plan for a ride both ways if possible, since you’ll be taking the first dose before you even arrive.
How to Get a Prescription in Time
Don’t wait until the day before your scan to think about this. The process for getting a sedation prescription varies depending on your healthcare system. In some cases, the doctor who ordered your MRI can write the prescription directly. In others, you’ll need to contact the radiology department, because some primary care practices consider MRI sedation outside their scope and will redirect you to the imaging team.
Call your imaging center as soon as your scan is booked. Ask whether they have their own sedation protocol or whether you need a prescription from your referring doctor. Some centers stock oral sedatives on-site and can administer them when you arrive. Others expect you to fill a prescription at a pharmacy beforehand and take it at home before heading in. Knowing this early prevents a last-minute scramble that only adds to your stress.
Over-the-Counter Antihistamines
If your anxiety is mild, or if you can’t get a prescription in time, certain antihistamines have a calming, sedating effect. Diphenhydramine (the active ingredient in Benadryl) is widely available and produces drowsiness that can take the edge off. Hydroxyzine is a stronger option that has actually been studied head-to-head against benzodiazepines for anxiety and performed comparably in some trials, though it’s prescription-only in most countries.
Antihistamines won’t eliminate real claustrophobia the way a benzodiazepine will, but they can help if your concern is more general nervousness than full-blown panic. They also tend to have a milder effect on coordination and judgment, though you should still be cautious about driving if you feel noticeably drowsy. Take diphenhydramine about 30 to 60 minutes before your appointment to give it time to kick in.
Non-Drug Strategies That Actually Help
Several techniques can reduce MRI anxiety on their own or alongside medication. These are worth trying even if you do take something, because the calmer you are going in, the less likely you are to need a second dose or to move during the scan.
- Controlled breathing: Slow, deep breaths with a longer exhale than inhale (for example, inhale for four counts, exhale for six) activate your body’s relaxation response. Practice this in the days before your scan so it feels automatic.
- Music or audio: Most MRI facilities offer headphones or earplugs. Bring a playlist or ask if they can play music. The scanner is loud, and having something familiar to focus on helps enormously.
- Eye covering: Many people find it easier not to see how close the scanner bore is. Ask the technologist for a washcloth or bring a simple cloth to drape over your eyes. Any covering you bring into the scanner must be completely metal-free, so skip sleep masks with wire nose bridges or magnetic clasps.
- Feet-first positioning: Depending on which body part is being scanned, you may be able to enter the machine feet-first, which keeps your head closer to the open end. Ask about this when you schedule.
- Squeeze ball: Most facilities provide a call button or squeeze ball connected to the technologist. Knowing you can stop the scan at any moment gives you a sense of control that reduces panic.
IV Sedation and General Anesthesia
For people with severe claustrophobia who cannot complete a scan even with oral medication, deeper sedation is available. IV sedation delivers medication directly into a vein, allowing the clinical team to adjust the dose in real time. You’ll be drowsy and may not remember the procedure, but you’re still breathing on your own.
General anesthesia, where you’re fully unconscious, is less common for adults but is sometimes used for children or patients who cannot hold still for other medical reasons. It requires an anesthesiologist, a dedicated recovery period, and fasting beforehand (typically nothing to eat or drink for several hours). Both IV sedation and general anesthesia need to be arranged well in advance and are usually performed at a hospital-based imaging center rather than a standalone clinic.
What to Do the Night Before
If you’re taking a prescription sedative, confirm whether you need to fast. For a simple oral tablet like lorazepam, most facilities do not require fasting because you remain conscious and your protective reflexes stay intact. If you’re receiving IV sedation or anesthesia, fasting for six to eight hours is standard.
Get a normal night’s sleep. Being overtired can paradoxically increase anxiety. Avoid caffeine the morning of your scan if you tend toward nervousness, and wear comfortable, metal-free clothing so you don’t have to change into a gown, which can add to the feeling of being in a medical setting. Arriving a few minutes early gives you time to settle in rather than rushing from the parking lot straight onto the table.
If you’ve tried an MRI before and couldn’t finish, mention that when you schedule. Facilities deal with this regularly and can build extra time into your appointment, assign a particularly patient technologist, or set up sedation options you might not have known were available.