Sertraline in symptomatic chronic breathlessness: a double blind, randomised trial

Currow, David C.; Louw, Sandra; Hill, Julie; Fazekas, Belinda; Clark, Katherine; Davidson, Patricia M.; McDonald, Christine F; Sajkov, Dimitar; McCaffrey, Nikki; Doogue, Matthew; Abernethy, Amy P.; Agar, Meera

doi:10.1183/13993003.congress-2018.pa2047

Cited by 1 publication

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“…Although our knowledge of the role of the brain in breathlessness perception has greatly increased in the last decade, this has not yet led to clinically applicable improvements for patients. In randomized controlled trials neither antidepressants nor anxiolytic drugs have been proven to alter the experience of patients with refractory breathlessness [12,13]. However, the viewpoint that traumatic breathlessness episodes may lead to PTSD symptoms which aggravate breathlessness, has not been explored before.…”

Section: Introductionmentioning

confidence: 99%

“When I am breathless now, I don’t have the fear that’s linked to it.” A case series on the potential of EMDR to break the dyspnea-anxiety cycle in COPD

Mooren

Smit

Engels

et al. 2022

Preprint

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BackgroundExpectations can enhance the intensity and the neural processing of breathlessness. Previous breathlessness episodes may have a psychotraumatic effect and may influence perception of subsequent episodes. In post-traumatic stress disorder, eye movement desensitization and reprocessing (EMDR) is the therapy of choice. Aims and objectivesWe explored the hypothesis that EMDR in patients with chronic obstructive pulmonary disease (COPD) and previous severe breathlessness episodes improves breathlessness mastery by decreasing the anxiety component. MethodsSince there is no previous research on this subject, we undertook a qualitative case series to explore it. We included four patients with COPD GOLD 4/D and refractory breathlessness who wished to undergo EMDR for traumatic breathlessness episodes. Amongst others, we used the Chronic Respiratory Disease Questionnaire (CRQ) before and after EMDR, and semi-structured, face-to-face, in-depth interviews.ResultsAll patients had between 3 and 5 EMDR sessions. On CRQ, subset mastery, 3 patients had a large improvement and 1 patient a moderate improvement. On subset emotional functioning, 3 patients showed a large clinically relevant improvement and 1 patient showed no change. All patients made a distinction between ‘regular’ breathlessness and breathlessness intertwined with anxiety. They all stated that the anxiety component of their breathlessness diminished or disappeared. When asked whether they would recommend EMDR for other COPD patients, all four subjects answered positively.ConclusionsThere is ground for a randomized controlled clinical trial to test the effect of EMDR on breathlessness mastery in a subset of COPD patients with previous severe breathlessness episodes and high levels of anxiety.

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Section: Introductionmentioning

confidence: 99%

“When I am breathless now, I don’t have the fear that’s linked to it.” A case series on the potential of EMDR to break the dyspnea-anxiety cycle in COPD

Mooren

Smit

Engels

et al. 2022

Preprint

View full text Add to dashboard Cite

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Sertraline in symptomatic chronic breathlessness: a double blind, randomised trial

Abstract: Take Home Message Chronic breathlessness generates suffering late in life. In this setting, titrated sertraline had similar benefits and harms to placebo in an adequately powered, multi-site, double blind, randomised controlled trial at four weeks.

Cited by 1 publication

References 29 publications

“When I am breathless now, I don’t have the fear that’s linked to it.” A case series on the potential of EMDR to break the dyspnea-anxiety cycle in COPD

“When I am breathless now, I don’t have the fear that’s linked to it.” A case series on the potential of EMDR to break the dyspnea-anxiety cycle in COPD

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