Drug therapy for symptoms associated with anxiety in adult

palliative care patients (Review)

Candy B, Jackson KC, Jones L, Tookman A, King M

This is a reprint of a Cochrane review, prepared and maintained by The Cochrane Collaboration and published in The Cochrane Library
2012, Issue 10
http://www.thecochranelibrary.com

Drug therapy for symptoms associated with anxiety in adult palliative care patients (Review)
Copyright 2012 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.

[Intervention Review]

Drug therapy for symptoms associated with anxiety in adult

palliative care patients
Bridget Candy1 , Kenneth C Jackson2 , Louise Jones1 , Adrian Tookman1 , Michael King3
1 Marie

Curie Palliative Care Research Unit, UCL Mental Health Sciences Unit, University College Medical School, London, UK.
Practice School of Pharmacy, Columbia Campus, South University, Columbia, SC, USA. 3 UCL Mental Health Sciences,
University College Medical School, London, UK
2 Pharmacy

Contact address: Bridget Candy, Marie Curie Palliative Care Research Unit, UCL Mental Health Sciences Unit, University College Medical School, Charles Bell House, 67 - 73 Riding House Street, London, W1W 7EJ, UK. b.candy@ucl.ac.uk. bridget@metaclarity.com.
Editorial group: Cochrane Pain, Palliative and Supportive Care Group.
Publication status and date: New search for studies and content updated (no change to conclusions), published in Issue 10, 2012.
Review content assessed as up-to-date: 22 January 2012.
Citation: Candy B, Jackson KC, Jones L, Tookman A, King M. Drug therapy for symptoms associated with anxiety in adult palliative care
patients. Cochrane Database of Systematic Reviews 2012, Issue 10. Art. No.: CD004596. DOI: 10.1002/14651858.CD004596.pub2.
Copyright 2012 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.

ABSTRACT
Background
This is an update of the review published on Drug therapy for anxiety in adult palliative care patients in Issue 1, 2004 of The Cochrane
Library. Anxiety is common in palliative care patients. It can be a natural response to impending death, but it may represent a clinically
significant issue in its own right. It may also result from pain, or other untreated or poorly managed symptoms. When anxiety is severe
or distressing drug therapy may be considered in addition to supportive care.
Objectives
This review aimed to identify and evaluate randomised controlled trials examining the effectiveness of drug therapy for symptoms of
anxiety in adult palliative care patients.
Search methods
We searched the following sources: CENTRAL (The Cochrane Library 2012, Issue 2), MEDLINE (1966 to 2012), EMBASE (1980 to
2012), CINAHL (1982 to 2012), PsycLit (1974 to 2000) and PsycInfo (1990 to 2012) for literature pertaining to this topic published
in any language using a detailed search strategy.
Selection criteria
We sought prospective, randomised trials, with or without blinding, involving the use of drug therapy for the treatment of symptoms of
anxiety in adult palliative care patients. Pharmacological agents included 5-HT3 receptor antagonists, anxiolytic agents, antiepileptic
agents, antidepressive agents, antipsychotic agents, benzodiazepines, butyrophenones, phenothiazines, antihistamines, barbiturates,
sedative hypnotics, antiepileptic drugs and beta-blockers.
Data collection and analysis
We identified and excluded six studies using the original search strategy, with a further two studies being identified and excluded for
this 2012 update. We therefore identified a total of eight potential studies but none met the criteria for inclusion in this review.
Drug therapy for symptoms associated with anxiety in adult palliative care patients (Review)
Copyright 2012 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.

Main results
No data were available to enable an assessment to be made of the effectiveness of drugs to treat symptoms of anxiety in palliative care
patients.
Authors conclusions
There remains insufficient evidence to draw a conclusion about the effectiveness of drug therapy for symptoms of anxiety in adult
palliative care patients. To date no studies have been found that meet the inclusion criteria for this review. Prospective controlled clinical
trials are required in order to establish the benefits and harms of drug therapy for the treatment of anxiety in palliative care.

PLAIN LANGUAGE SUMMARY

Drug therapy for anxiety in palliative care
Anxiety is a common symptom in patients near the end of life. As with other areas of palliative care, the majority of available literature
pertaining to drug therapy for anxiety is based on the reporting of anecdotes. A search of the international literature for randomised
clinical trials in the area of drug therapy for symptoms of anxiety in palliative care yielded no results. As a consequence, it is not possible
to assess the effectiveness of treatment options. It is hoped that this review will motivate future research in this area.

Drug therapy for symptoms associated with anxiety in adult palliative care patients (Review)
Copyright 2012 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.