Benefit–Risk Assessment of Psychotropic Drugs in Older Patients with Chronic Obstructive Pulmonary Disease

Yohannes, A.M.; Jin, Jeff Wang; Kunik, Mark E.

doi:10.1007/s40266-022-00935-0

Cited by 7 publications

(5 citation statements)

References 64 publications

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Section: Pharmacology Therapymentioning

confidence: 99%

“…A recent critical review examined benzodiazepine use in the treatment of insomnia, breathlessness and anxiety in patients with COPD 28 . In the short term, a low-dose benzodiazepine effectively reduced anxiety and insomnia 28 . A nationwide study in Sweden, in patients with severe COPD on long-term oxygen therapy, identified that concurrent use of benzodiazepines and opioids in low doses was not associated with an elevated risk of hospital admission or mortality 29 .…”

Section: Pharmacology Therapymentioning

confidence: 99%

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Anxiety and post-traumatic stress disorders in patients with chronic respiratory diseases

Yohannes

2023

Current Opinion in Supportive &Amp; Palliative Care

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Purpose of review This brief critical review evaluates recent research on the impact of anxiety disorders and post-traumatic stress disorders (PTSD) on patients with chronic obstructive pulmonary disease (COPD) and asthma. In these patients, untreated anxiety and PTSD exacerbate acute symptoms, increase disability and impair quality of life. Therefore, effective interventions are also reviewed. Recent findings Anxiety disorders and PTSD are prevalent in COPD and asthma, worsen symptoms in acute exacerbations, and increase morbidity and healthcare utilization. Pulmonary rehabilitation (PR), cognitive behavioural therapy and pharmacological therapy are each effective in COPD patients with anxiety or PTSD. However, very little work examined therapy for combined anxiety and PTSD in patients with either COPD or asthma. Summary Despite the high prevalence of anxiety disorder or PTSD in patients with chronic respiratory diseases, a paucity of literature remains demonstrating the efficacy of pharmacological therapies for these conditions. This review highlights the promising benefits of PR on anxiety, but prospective trials are needed to demonstrate the efficacy of interventions with PTSD alone, or with concomitant anxiety.

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Section: Pharmacology Therapymentioning

confidence: 99%

Section: Pharmacology Therapymentioning

confidence: 99%

Anxiety and post-traumatic stress disorders in patients with chronic respiratory diseases

Yohannes

2023

Current Opinion in Supportive &Amp; Palliative Care

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“…Studies indicate a relationship between the dosage of psychotropic drugs and the occurrence of acute respiratory failure in COPD patients, restricting the clinical use of antipsychotics in COPD patients with comorbid anxiety and depression. More well-designed clinical controlled trials are needed to supplement whether antipsychotic medications are widely applicable for improving and alleviating adverse emotions in COPD patients [39,40]. Traditional Chinese medicine has made considerable progress in treating COPD with comorbid anxiety and depression.…”

Section: Progress In the Treatment Of Adverse Emotions In Copd Patientsmentioning

confidence: 99%

Research Progress on Influencing Factors, Mechanisms, and Therapeutic Regimens of Adverse Emotions in COPD Patients

Xiao,

2023

IJCEMR

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Chronic obstructive pulmonary disease (COPD) is a serious respiratory system disease in China and even the world, which seriously affects patients' health and quality of life. In addition to COPD symptoms, the accompanying anxiety, depression, and other adverse emotions have gradually attracted widespread attention. Based on the summary of previous literature, this article summarizes the influencing factors of adverse emotions in COPD patients, including smoking, chronic pain, activity limitation, drug effect, gender, fatigue, etc. Clinical treatment can be taken through continuous and close observation of the influencing factors of adverse emotions, and timely and effective intervention measures can be taken for high-risk groups. At present, the exact pathogenesis of anxiety and depression in COPD patients is still unclear. It involves multiple complex pathophysiological factors such as hypoxemia and chronic inflammation, which may also include behavioral factors such as active smoking and tobacco addiction, as well as other factors such as social isolation, complications, declined physical function, and frequent re-hospitalization. This study summarizes several mechanisms such as hyperventilation, carbon dioxide retention, hypoxemia, inflammation, immune regulation, cognitive behaviors, and sleep disorders so as to determine the possible mechanisms of anxiety, depression, and other adverse emotions in COPD patients and to assist the clinical search for effective therapeutic targets. Finally, this article summarizes the treatment progress of adverse emotions in COPD patients mainly through antipsychotics and TCM therapy, individualized breathing intervention, and cognitive behavioral therapy.

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“…Additionally, patients with depression display noticeably higher levels of inflammatory cytokines than healthy controls [11]. To survey the effect of serum Th1/Th2 cytokines on pulmonary function and depressive symptoms in patients with COPD, a large-scale prospective cohort study found that inflammatory cytokines may mediate the occurrence of depressive symptoms and the decrease in pulmonary function in patients with COPD, and that depressive complications may affect the quality of life, disease progression, and prognosis of patients with COPD [12][13][14].…”

Section: Introductionmentioning

confidence: 99%

Relationship between serum Th1/Th2 imbalance and depression in elderly patients with COPD and its clinical implications

Zhang,

Wang,

et al. 2023

THC

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BACKGROUND: Chronic obstructive pulmonary disease (COPD) causes organic damage as well as anxiety, depression, fear, and other psychological disorders, which seriously affect the quality of life and prognosis of patients and cause a huge economic burden to the family and society. OBJECTIVE: The aim of this study was to investigate the correlation between an imbalance of serum Th1/Th2 indicators and psychiatric depression in elderly patients with COPD and analyze its implications for clinical management. METHODS: From January 2018 to May 2022, 120 elderly patients with COPD treated at our hospital were categorized into two groups based on the self-rating depression scale (SDS): COPD with depression (SDS score ⩾ 50) and COPD alone (SDS score < 50). Blood gas analysis, pulmonary function, and serum Th1/Th2 index were determined. Receiver operating characteristic (ROC) curves were analyzed to explore the diagnostic value of serum Th1/Th2 ratios for COPD complicated by depression. RESULTS: Compared with the group without depression, the partial pressure of carbon dioxide and COPD assessment test scores were significantly higher, and the oxygenation index, forced expiratory volume in one second (FEV1), and percent predicted FEV1 were significantly lower in the COPD with depression group (P< 0.05). Interleukin (IL)-1β, IL-2, IL-6, IL-8, IL-10, and tumor necrosis factor-α (TNF-α) were significantly higher in the COPD with depression group than in the group without depression (P< 0.05). Logistic regression analysis indicated that the imbalance of serum IL-1β, IL-2, IL-6, IL-8, IL-10, and TNF-α was a risk factor for mental depression in elderly patients with COPD. When comparing prognostic indices, the interval before the first onset of clinically noticeable deterioration (CID-C) in the COPD with depression group was noticeably shorter than that in the COPD without depression group; the incidence of CID-C within 6 months was noticeably higher in the COPD with depression group than in the group without depression. CONCLUSION: Elderly patients with COPD and depression had reduced pulmonary function and higher serum Th1/Th2 levels, and an imbalance in serum Th1/Th2 indicators was a potential risk factor for depression. Moreover, elderly patients with COPD and depression were at a higher risk of disease progression and had a worse prognosis. Thus, an imbalance in serum Th1/Th2 indicators is a potential prognostic factor for evaluating depression in patients with COPD.

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Benefit–Risk Assessment of Psychotropic Drugs in Older Patients with Chronic Obstructive Pulmonary Disease

Cited by 7 publications

References 64 publications

Anxiety and post-traumatic stress disorders in patients with chronic respiratory diseases

Anxiety and post-traumatic stress disorders in patients with chronic respiratory diseases

Research Progress on Influencing Factors, Mechanisms, and Therapeutic Regimens of Adverse Emotions in COPD Patients

Relationship between serum Th1/Th2 imbalance and depression in elderly patients with COPD and its clinical implications

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