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

Barbetta, Carlo; Currow, David C.; Johnson, Miriam J.

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.

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. https://doi.org/10.1080/17476348.2017.1305896

• Journal Article Type: Review
• Acceptance Date: Mar 9, 2017
• Online Publication Date: Mar 17, 2017
• Publication Date: Apr 3, 2017
• Deposit Date: Mar 23, 2017
• Publicly Available Date: Dec 7, 2018
• Journal: Expert review of respiratory medicine
• Print ISSN: 1747-6348
• Publisher: Taylor and Francis
• Peer Reviewed: Peer Reviewed
• Volume: 11
• Issue: 4
• Pages: 333-341
• DOI: https://doi.org/10.1080/17476348.2017.1305896
• Keywords: Breathlessness, Dyspnoea, Anxiolytic, Anti-depressant, Nebulized furosemide
• Public URL: https://hull-repository.worktribe.com/output/449932
• Publisher URL: http://www.tandfonline.com/doi/abs/10.1080/17476348.2017.1305896
• Additional Information: Peer Review Statement: The publishing and review policy for this title is described in its Aims & Scope.; Aim & Scope: http://www.tandfonline.com/action/journalInformation?show=aimsScope&journalCode=ierx20
• Contract Date: Mar 23, 2017