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Non-opioid medications for the relief of chronic breathlessness: current evidence

Journal Article


Abstract


  • Introduction: To evaluate systematically randomised clinical trials investigating non-opioid medications for the management and treatment of chronic breathlessness. Areas covered: The evidence for the role of benzodiazepines, anxiolytics, selective serotonin re-uptake inhibitors (SSRIs), tricyclic antidepressants, antihistamines, cannabinoids, nebulized furosemide and herbal-based treatments were critically reviewed. Search of the Clinical Trials Registry (Clinicaltrial.gov) identified ongoing studies expected to generate new data in the near future in several classes of non-opioid medications for their net effect on chronic breathlessness. Expert commentary: Morphine still has the best level of evidence for the symptomatic treatment of chronic breathlessness. Non-opioid treatments for chronic breathlessness are less studied than morphine and morphine-related medications although evidence is emerging in relation to some options. Currently, there is insufficient evidence to recommend non-opioids in the routine treatment of chronic breathlessness. There is a need to find agents, new as well as re-purposed, that can be used as alternative therapies to opioids for chronic breathlessness for people who are unable to tolerate morphine.

Publication Date


  • 2017

Citation


  • Barbetta, C., Currow, D. C., & Johnson, M. J. (2017). Non-opioid medications for the relief of chronic breathlessness: current evidence. Expert Review of Respiratory Medicine, 11(4), 333-341. doi:10.1080/17476348.2017.1305896

Scopus Eid


  • 2-s2.0-85016294556

Start Page


  • 333

End Page


  • 341

Volume


  • 11

Issue


  • 4

Place Of Publication


Abstract


  • Introduction: To evaluate systematically randomised clinical trials investigating non-opioid medications for the management and treatment of chronic breathlessness. Areas covered: The evidence for the role of benzodiazepines, anxiolytics, selective serotonin re-uptake inhibitors (SSRIs), tricyclic antidepressants, antihistamines, cannabinoids, nebulized furosemide and herbal-based treatments were critically reviewed. Search of the Clinical Trials Registry (Clinicaltrial.gov) identified ongoing studies expected to generate new data in the near future in several classes of non-opioid medications for their net effect on chronic breathlessness. Expert commentary: Morphine still has the best level of evidence for the symptomatic treatment of chronic breathlessness. Non-opioid treatments for chronic breathlessness are less studied than morphine and morphine-related medications although evidence is emerging in relation to some options. Currently, there is insufficient evidence to recommend non-opioids in the routine treatment of chronic breathlessness. There is a need to find agents, new as well as re-purposed, that can be used as alternative therapies to opioids for chronic breathlessness for people who are unable to tolerate morphine.

Publication Date


  • 2017

Citation


  • Barbetta, C., Currow, D. C., & Johnson, M. J. (2017). Non-opioid medications for the relief of chronic breathlessness: current evidence. Expert Review of Respiratory Medicine, 11(4), 333-341. doi:10.1080/17476348.2017.1305896

Scopus Eid


  • 2-s2.0-85016294556

Start Page


  • 333

End Page


  • 341

Volume


  • 11

Issue


  • 4

Place Of Publication