Should Benzodiazepines be Used for Reducing Dyspnea in Patients with Advanced Illnesses?
Simon, Steffen T. ; Mori, Masanori ; Ekström, Magnus LU
; Pralong, Anne
; Yamaguchi, Takashi
and Hui, David
(2023)
In Journal of Pain and Symptom Management
65(3).
p.219-223
- Abstract
Dyspnea is a common and highly distressing symptom in patients with advanced illnesses. Many patients continue to experience chronic dyspnea despite optimal management of underlying disease(s) and various non-pharmacologic interventions, necessitating the consideration of pharmacologic therapies for palliation of dyspnea. One commonly asked question by clinicians is whether benzodiazepines have a role in the palliation of dyspnea. In this “Controversies in Palliative Care” article, three groups of thought leaders independently answer this question. Specifically, each group provides a synopsis of the key studies that inform their thought processes, share practical advice on their clinical approach, and highlight the opportunities for... (More)
Dyspnea is a common and highly distressing symptom in patients with advanced illnesses. Many patients continue to experience chronic dyspnea despite optimal management of underlying disease(s) and various non-pharmacologic interventions, necessitating the consideration of pharmacologic therapies for palliation of dyspnea. One commonly asked question by clinicians is whether benzodiazepines have a role in the palliation of dyspnea. In this “Controversies in Palliative Care” article, three groups of thought leaders independently answer this question. Specifically, each group provides a synopsis of the key studies that inform their thought processes, share practical advice on their clinical approach, and highlight the opportunities for future research. All three groups suggest that benzodiazepines alone do not confer a benefit for dyspnea in advanced illnesses based on existing data. They also expressed concerns about the potential adverse effects such as delirium and drowsiness and recommended against benzodiazepines as first line pharmacologic therapy. Some groups suggest that benzodiazepines may be used in highly selected patients with severe anxiety associated with dyspnea. Some investigators may also consider the adjunctive use of benzodiazepines in patients with severe dyspnea despite opioids, particularly if life expectancy is limited. Benzodiazepines also have a role in palliative sedation for refractory dyspnea in the last days of life. More research is needed to confirm the benefit of benzodiazepines in these populations.
(Less)
- author
- Simon, Steffen T.
; Mori, Masanori
; Ekström, Magnus
LU
; Pralong, Anne
; Yamaguchi, Takashi
and Hui, David
- organization
- publishing date
- 2023
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Benzodiazepines, drug therapy, dyspnea, palliative care, respiratory, signs and symptoms
- in
- Journal of Pain and Symptom Management
- volume
- 65
- issue
- 3
- pages
- 219 - 223
- publisher
- Elsevier
- external identifiers
-
- scopus:85145333782
- pmid:36455801
- ISSN
- 0885-3924
- DOI
- 10.1016/j.jpainsymman.2022.11.018
- language
- English
- LU publication?
- yes
- id
- 06b507e9-c14d-4eaa-ba25-e2fcad19fa00
- date added to LUP
- 2023-02-09 11:49:02
- date last changed
- 2024-06-11 13:12:13
@misc{06b507e9-c14d-4eaa-ba25-e2fcad19fa00,
abstract = {{<p>Dyspnea is a common and highly distressing symptom in patients with advanced illnesses. Many patients continue to experience chronic dyspnea despite optimal management of underlying disease(s) and various non-pharmacologic interventions, necessitating the consideration of pharmacologic therapies for palliation of dyspnea. One commonly asked question by clinicians is whether benzodiazepines have a role in the palliation of dyspnea. In this “Controversies in Palliative Care” article, three groups of thought leaders independently answer this question. Specifically, each group provides a synopsis of the key studies that inform their thought processes, share practical advice on their clinical approach, and highlight the opportunities for future research. All three groups suggest that benzodiazepines alone do not confer a benefit for dyspnea in advanced illnesses based on existing data. They also expressed concerns about the potential adverse effects such as delirium and drowsiness and recommended against benzodiazepines as first line pharmacologic therapy. Some groups suggest that benzodiazepines may be used in highly selected patients with severe anxiety associated with dyspnea. Some investigators may also consider the adjunctive use of benzodiazepines in patients with severe dyspnea despite opioids, particularly if life expectancy is limited. Benzodiazepines also have a role in palliative sedation for refractory dyspnea in the last days of life. More research is needed to confirm the benefit of benzodiazepines in these populations.</p>}},
author = {{Simon, Steffen T. and Mori, Masanori and Ekström, Magnus and Pralong, Anne and Yamaguchi, Takashi and Hui, David}},
issn = {{0885-3924}},
keywords = {{Benzodiazepines; drug therapy; dyspnea; palliative care; respiratory; signs and symptoms}},
language = {{eng}},
number = {{3}},
pages = {{219--223}},
publisher = {{Elsevier}},
series = {{Journal of Pain and Symptom Management}},
title = {{Should Benzodiazepines be Used for Reducing Dyspnea in Patients with Advanced Illnesses?}},
url = {{http://dx.doi.org/10.1016/j.jpainsymman.2022.11.018}},
doi = {{10.1016/j.jpainsymman.2022.11.018}},
volume = {{65}},
year = {{2023}},
}