Medication for Fear in Palliative Care

Matthias Girke, Ulrike Steurer, Irene Stilz

Last update: 27.08.2018

Fear and anxiety require an individual therapy which considers the patient’s preferences and values. In addition to symptomatic control, which can be achieved through medication and other established treatment methods, patients often wish for the possibility to transform anxiety and an increase their own innate capacities for dealing with fear. The interaction of medications with external applications, body-oriented therapies, art therapy, psychotherapy and pastoral care can achieve convincing results for patients and the use of anxiolytics can be avoided or significantly reduced.

Fear can lead to inner tension with experiences of shock, or inner agitation and panic. Medication takes these polar deflections into account and tries not only to control the symptoms that come from changed mental activity, but also to balance the change through medication and to strengthen the effectiveness of the patient’s “I”-organization in the face of anxiety. Fear is often described as an agitated experience that “rises up from below”. Improvement can be achieved through external applications: these direct the sentient organization (soul organization) which has become too strongly oriented to the neurosensory system, into the motor-metabolic system. Some therapeutic nursing applications (e.g., external applications in the area of the lower legs and feet) follow this principle. A compress with aurum lavender heart ointment is a helpful therapeutic nursing application. This treatment strengthens the patient’s sense of being able to cope and has an anxiety-relieving effect via the lavender aroma. It not only lessens the fear, it also reduces the powerlessness experienced with fear and strengthens the patient’s own ability to deal with the fear.

Anxiety with tension, mental strain

  • Cuprum metallicum praeparatum D6 trit. WELEDA 3x/d 1 saltsp.

Copper is indicated for cramp-like complaints, it can release the soul in cases of shock-like tension and draws the soul-spiritual being into the upbuilding metabolism.

  • Cuprum metallicum praeparatum D6, D20 amp. WELEDA 1 amp./d s.c. and as needed

can be used parenterally in this indication. The lower potency is for full-bodied, metabolic constitutions, the high potency for neurasthenic patients. In cases of “rigid” anxiety with spasmodic pain, it is effective to combine the injection with 2.5–5 (–10) mg morphine.

  • Cuprum metallicum praeparatum (ointment) 0.4% WELEDA or apply
  • Red Copper Ointment WALA to both lower legs in the evening in cases of anxiety with cool extremities.

Fear with a depressive mood and despondency

  • Hypericum Auro cultum, ex herba D2 dil. WELEDA, Hypericum Auro cultum Rh D3 dil. WELEDA 3x/d 20 gtt. or 1x/d Hypericum Auro cultum Rh D2, D3 amp. WELEDA 1 amp. mane.

The antidepressant effect of St. John’s wort is known. It is not the individual active ingredient that is decisive for our understanding of this medicinal plant, but its composition of substances. Its composition is an expression of the immaterial nature of this plant that blossoms around the summer solstice and absorbs light and warmth into its life processes, thereby able to brighten the mental “lack of light” in depressed patients. Gold shows a similar therapeutic quality through its combination of gravity and light and it is absorbed, through the life processes of this medicinal plant, over several generations of plants.

  • Ferrum sidereum D20 tabs. WELEDA 1x/d 1 tab. mane.

Iron activates the soul and spirit of the human being and leads them to increased activity in the organism. Iron deficient anemia demonstrates the opposite activity of the subtle members in mental adynamia, weakened regenerative life processes, and physical symptoms. Meteoric iron can increase the inner strength of the patient in cases of discouragement.

  • Pallasit D2 (ointment) WELEDA, apply thinly to both calves in the mornings .

This ointment, with added stony-iron meteorite with chrysolite, a natural magnesium iron silicate, activates the “I”-organization.

Fear with shortness of breath

  • Carbo Betulae D8, D20 amp. WELEDA 1x/d 1 ml s.c. up to several times daily

if necessary in combination with morphine 2.5–10 mg.

Charcoal is related to respiration (as in the “air hunger” of activated carbon). Charcoal concentrates the carbon that would otherwise be in the atmosphere as carbon dioxide by binding the oxygen. Charcoal prevents “hypercapnia” and “hypoxia” of the earth’s atmosphere. This process-related (as opposed to a substance-analytical) understanding of charcoal leads to its use in dyspnea of various causes. Its effectiveness—an easing of the fear associated with dyspnea—must be assessed after a short time.

Fear of “losing one’s center”

  • Aurum/Stibium/Hyoscyamus amp. WALA for s.c. injection or oral administration several times a day and as required.

This medication has an ordering effect on the soul (stibium), it centers the patient and supports him in finding his inner center (aurum). Hyoscyamus is effective against agitation, it has a warming and relaxing effect.

  • Aurum comp. amp. WALA 1x/d 1 amp. mane and as needed

has been successfully used for various anxiety syndromes and also for the fear of dying.

The following medications can be used in cases of threatening fear:

  • Olibanum comp. amp. WELEDA (contains Aurum met. praep. D30, Myrrha D6 and Olibanum D12) or Aurum comp. amp. WALA (contains Aurum met. praep. D6, Myrrha D3, Olibanum D3)
  • Aurum D10/Ferrum sidereum D10 aa amp. WELEDA
  • Aurum/Hyoscyamus comp. amp. WELEDA (contains Aurum met. praep. D10, Hyoscyamus D5, Stibium met. praep. D6) or Aurum/Stibium/Hyoscyamus amp. WALA (contains Aurum met. D9, Hyoscyamus niger D4, Stibium met. D7)

Fear with anxiety

  • Bryophyllum 50% trit. WELEDA 3 x ½ tsp., if necessary also for agitation and—due to its sleep-inducing effect—additionally ½ tsp. at night.

This medicinal plant develops a pronounced vegetative and regenerative power. It draws the human soul (soul organization) from agitated activity into the constructive activity of the life organization. Patients taking this medication quickly feel more centered, more balanced and calmed, and experience a renewed sense of being able to deal with their agitation.

  • Bryophyllum D5/Conchae D7 aa 1 ml, 10 ml amp. WELEDA
  • Aurum/Stibium/Hyoscyamus pill., amp. WALA: ampoules sublingual; Aurum/Hyoscyamus comp. trit., amp. WELEDA ampoules s.c. if required
  • Aurum D10/Ferrum sidereum D10 aa amp. WELEDA
  • Hyoscyamus/Valeriana amp. WELEDA s.c.
  • Gencydo® up to 5% amp. WELEDA s.c. in the calf: medication to relieve anxiety and panic attacks


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