Nübling G, Allmendinger S, Lorenzl S
Interdisziplinäres Zentrum für Palliativmedizin, Klinikum Großhadern, Ludwig-Maximilians-Universität, Marchioninistr. 15, 81377, München, Deutschland.
Schmerz. 2012 Sep;26(5):537-49. doi: 10.1007/s00482-012-1241-6.
Pharmacological treatment of anxiety is an important part of drug treatment in palliative care. In this review we searched for the current evidence of pharmacological treatment of anxiety in palliative care.
A systematic search of PubMed, Embase, PsycLIT, PsycINFO, CINAHL for studies of anxiety in palliative care was carried out in January 2012. Furthermore we searched the Cochrane Library, references of literature and leading textbooks. Studies were identified and information was filled in a standardized extraction sheet. Studies have been categorized and anxiety as an endpoint determined.
A total of four controlled studies, three uncontrolled studies, two retrospective studies, one case report, two surveys, one systematic Cochrane review and one unsystematic review were analyzed and included in this review. This indicates an overall low number of studies for the pharmacological treatment of anxiety in palliative care. According to our results, benzodiazepines are the most commonly used drugs in palliative care. However, based on our review, there is no evidence-based recommendation for the therapeutic use in palliative care.
With the existing evidence no general recommendations for pharmacological treatment of anxiety in palliative care can be given. Even for the commonly used benzodiazepines, neuroleptics, antidepressants, antihistamines and beta blockers for the treatment of anxiety no evidence based recommendations can be made. However, these medications are commonly used to treat anxiety in other patient populations and can also be used in palliative care patients. According to our review we cannot recommend a single drug or give recommendations regarding the dosage of drugs. There is a strong need for randomized controlled trials to evaluate the effect of drug treatment of anxiety in palliative care patients. The English full text version of this article will be available in SpringerLink as of November 2012 (under "Supplemental").
焦虑症的药物治疗是姑息治疗中药物治疗的重要组成部分。在本综述中，我们探寻了姑息治疗中焦虑症药物治疗的当前证据。
2012年1月，我们对PubMed、Embase、PsycLIT、PsycINFO、CINAHL进行了系统检索，以查找有关姑息治疗中焦虑症的研究。此外，我们还检索了Cochrane图书馆、文献参考文献和主要教科书。识别出相关研究，并将信息填入标准化的提取表中。对研究进行了分类，并确定将焦虑作为一个终点指标。
本综述共分析并纳入了四项对照研究、三项非对照研究、两项回顾性研究、一份病例报告、两项调查、一项Cochrane系统评价和一项非系统评价。这表明姑息治疗中焦虑症药物治疗的研究总体数量较少。根据我们的结果，苯二氮䓬类药物是姑息治疗中最常用的药物。然而，基于我们的综述，对于姑息治疗中的治疗用途，尚无循证推荐。
根据现有证据，无法给出姑息治疗中焦虑症药物治疗的一般性建议。即使对于治疗焦虑症常用的苯二氮䓬类药物、抗精神病药物、抗抑郁药物、抗组胺药物和β受体阻滞剂，也无法给出循证推荐。然而，这些药物常用于治疗其他患者群体的焦虑症，也可用于姑息治疗患者。根据我们的综述，我们无法推荐单一药物或给出关于药物剂量的建议。迫切需要进行随机对照试验，以评估药物治疗对姑息治疗患者焦虑症的效果。本文的英文全文版本将于2012年11月在SpringerLink上提供（在“补充材料”下）。
