title: Non-opioid medications for the relief of chronic breathlessness: current evidence.
abstract: 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.
authors.affiliation: a Respiratory Unit , AAS5 Friuli Occidentale, S. Maria degli Angeli Hospital , Pordenone , Italy.
authors.forename: Carlo
authors.initials: C
authors.lastname: Barbetta
authors.affiliation: b Centre for Cardiovascular & Chronic Care, University of Technology , Sydney , Australia.|c Wolfson Palliative Care Research Centre , Hull York Medical School, The University of Hull , Hull , United Kingdom.
authors.forename: David C
authors.initials: DC
authors.lastname: Currow
authors.affiliation: c Wolfson Palliative Care Research Centre , Hull York Medical School, The University of Hull , Hull , United Kingdom.
authors.forename: Miriam J
authors.initials: MJ
authors.lastname: Johnson
mesh_terms: D002908:Chronic Disease; D004417:Dyspnea / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D006801:Humans
keywords: Breathlessness; anti-depressant; anxiolytic; dyspnoea; nebulized furosemide