The role of benzodiazepines in breathlessness: a single site, open label pilot of sustained release morphine together with clonazepam

dc.contributor.author Allcroft, Peter
dc.contributor.author Margitanovic, Vera
dc.contributor.author Greene, Aine
dc.contributor.author Agar, Meera Ruth
dc.contributor.author Clark, Katherine
dc.contributor.author Abernethy, Amy Pickar
dc.contributor.author Currow, David Christopher
dc.date.accessioned 2013-08-28T02:10:21Z
dc.date.available 2013-08-28T02:10:21Z
dc.date.issued 2013-04-18
dc.description.abstract Background: Breathlessness at rest or on minimal exertion despite optimal treatment of underlying cause(s) is distressing and prevalent. Opioids can reduce the intensity of chronic refractory breathlessness and an anxiolytic may be of benefit. This pilot aimed to determine the safety and feasibility of conducting a phase III study on the intensity of breathlessness by adding regular benzodiazepine to low-dose opioid. Methods: This is a single site, open label phase II study of the addition of regular clonazepam 0.5 mg nocte orally to KapanolR 10 mg (sustained release morphine sulphate) orally mane together with docusate/sennosides in people with modified Medical Research Council Scale ≥2. Breathlessness intensity on day four was the efficacy outcome. Participants could extend for another 10 days if they achieved >15% reduction over their own baseline breathlessness intensity. Results: Eleven people had trial medication (eight males, median age 78 years (68 to 89); all had COPD; median Karnofsky 70 (50 to 80); six were on long-term home oxygen. Ten people completed day four. One person withdrew because of unsteadiness on day four. Five participants reached the 15% reduction, but only three went on to the extension study, all completing without toxicity. Conclusion: This study was safe, feasible and there appears to be a group who derive benefits comparable to titrated opioids. Given the widespread use of benzodiazepines for the symptomatic treatment of chronic refractory breathlessness and its poor evidence base, there is justification for a definitive phase III study. en
dc.identifier.citation Allcroft, P., Margitanovic, V., Greene, A., Agar, M.R., Clark, K., Abernethy, A.P. and Currow, D.C., 2013. The role of benzodiazepines in breathlessness: a single site, open label pilot of sustained release morphine together with clonazepam. Journal of Palliative Medicine, 16(7), 741-744. en
dc.identifier.doi https://doi.org/10.1089/jpm.2012.0505 en
dc.identifier.issn 1096-6218
dc.identifier.uri http://hdl.handle.net/2328/27009
dc.language.iso en
dc.publisher Mary Ann Liebert, Inc. en
dc.rights.holder (C) Mary Ann Liebert, Inc. 2013 en
dc.rights.license In Copyright
dc.subject Palliative care
dc.title The role of benzodiazepines in breathlessness: a single site, open label pilot of sustained release morphine together with clonazepam en
dc.type Article en
local.contributor.authorOrcidLookup Currow, David Christopher: https://orcid.org/0000-0003-1988-1250 en_US
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