TY - JOUR T1 - Opioids for breathlessness: Psychological and neural factors influencing response variability JF - European Respiratory Journal JO - Eur Respir J DO - 10.1183/13993003.00275-2019 SP - 1900275 AU - Sara J. Abdallah AU - Olivia K. Faull AU - Vishvarani Wanigasekera AU - Sarah L. Finnegan AU - Dennis Jensen AU - Kyle Pattinson Y1 - 2019/01/01 UR - http://erj.ersjournals.com/content/early/2019/05/01/13993003.00275-2019.abstract N2 - Chronic breathlessness is a multidimensional and aversive symptom, which is often poorly explained by underlying pathophysiology [1]. For many patients, breathlessness is refractory to maximal medical therapies that target disease processes [2]. However, opioids are thought to be a possible therapeutic avenue to treat symptomology independently of disease [3]. Importantly, research in chronic pain has demonstrated that qualities such as anxiety and depression (collectively termed negative affect here) can both exacerbate symptoms [4] and reduce opioid efficacy [5, 6]. Therefore, it may be pertinent to consider such behavioural factors when contemplating the use of opioids for breathlessness.FootnotesThis manuscript has recently been accepted for publication in the European Respiratory Journal. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJ online. Please open or download the PDF to view this article.Conflict of interest: Dr. Abdallah has nothing to disclose.Conflict of interest: Dr. Faull reports personal fees from Nektar Pharmaceuticals, outside the submitted work.Conflict of interest: Dr. Wanigasekera reports grants from National Institute for Health Research Oxford Biomedical Research Centre (Oxford, United Kingdom) during the conduct of the study.Conflict of interest: Dr. Finnegan has nothing to disclose.Conflict of interest: Dr. Jensen reports grants from Banting Research Foundation/Rx&D Health Research Foundation Award, during the conduct of the study; grants and personal fees from AstraZeneca, grants from Boehringer Ingelheim, grants from Tilray, grants from Novartis, outside the submitted work.Conflict of interest: Dr. Pattinson reports personal fees from Nektar Pharmaceuticals, outside the submitted work. ER -