The therapeutics of dyspnoea.

In summary, our current understanding of the therapeutics of dyspnoea is inadequate and leaves plenty of room for improvement. Rationalization of the management of this symptom has the potential to improve the quality of life of countless patients with both malignant and non-malignant disease. To date, research studies addressing this issue are sparse. Those that have been conducted are incomplete in that almost all have assessed only the effect of single dose interventions in normal volunteers or patients with COPD. There is no information on either long term dosing with these drugs or their use in patients with cancer related breathlessness. It is possible that other pharmacological agents that have never been used for this indication may have therapeutic potential. The pharmacological treatment of breathlessness deserves further investigation, and clinical studies should be conducted in parallel with appropriate laboratory studies. Drug therapy is, however, but one aspect of the overall management of any symptom, and a thorough assessment of the role of non-drug interventions for dyspnoea is also essential. Well designed multicentre studies are urgently required to evaluate the symptomatic treatment of breathlessness, but such studies must be preceded by the development of valid and sensitive patient rated tools to assess this distressing and common symptom.