Central nervous system effects of H1-receptor antagonists in the elderly
Identifieur interne : 000741 ( Main/Exploration ); précédent : 000740; suivant : 000742Central nervous system effects of H1-receptor antagonists in the elderly
Auteurs : F Estelle R. Simons ; Terry G. Fraser ; John Maher ; Neelan Pillay ; Keith J. SimonsSource :
- Annals of Allergy, Asthma & Immunology [ 1081-1206 ] ; 1999.
English descriptors
- Teeft :
- Additional objective tests, Adverse effects, Allergy, Allergy clin immunol, Antagonist, Antihistamines antagonists, Bartlett test, Cetirizine, Chlorpheniramine, Clin, Clin pharmacol, Cognitive, Cognitive processing, Crossover study, Diphenhydramine, Dosing, Elderly persons, Elderly subjects, Elderly volunteers, Epicutaneous tests, Flare areas, Health sciences, Histamine, Histamine phosphate, Immunol, Latency, Loratadine, Medication, Nervous system effects, Placebo, Predose values, Psychomotor performance, Research centre, Sample size, Schering canada, Sedative effects, Significant difference, Significant differences, Somnolence, Study days, Study design, System effects, System function, Test time, Variance, Visual analog scales, Visual analogue scale, Wheal, Young adults.
Abstract
Background The potential adverse central nervous system effects of H1-receptor antagonists have not been optimally studied in the elderly.Objective We hypothesized that newer H1-receptor antagonists such as cetirizine and loratadine would cause less central nervous system dysfunction than the older H1-receptor antagonists diphenhydramine and chlorpheniramine in this population, as they do in younger subjects.Methods We performed a randomized, double-blind, single-dose, placebo-controlled, 5-way crossover study in 15 healthy elderly subjects (mean age 71 SD 5 years). On study days at least 1 week apart, they received cetirizine 10 mg, loratadine 10 mg, diphenhydramine 50 mg, chlorpheniramine 8 mg, or placebo. Outcome measures, recorded before and 2 to 2.5 hours after dosing were latency of the P300 event-related potential in which increased latency reflects a decreased rate of cognitive processing, visual analogue scale for subjective somnolence, and histamine skin tests for measurement of peripheral H1-blockade.Results The changes in P300 following each treatment yielded variances that were not equal (P > .05), precluding usual statistical analysis of the means. These variances were ranked: chlorpheniramine > diphenhydramine > loratadine > placebo > cetirizine. The rank of mean differences in the visual analogue scale increase from pre-dose baseline was: diphenhydramine > chlorpheniramine > cetirizine > loratadine > placebo. All H1-receptor antagonists suppressed the histamine-induced wheal and flare significantly compared to baseline.Conclusion In the elderly, the new H1-receptor antagonists cetirizine and loratadine are less likely to cause adverse central nervous system effects than the old H1-antagonists chlorpheniramine or diphenhydramine, but this requires confirmation using additional objective tests of central nervous system function.
Url:
DOI: 10.1016/S1081-1206(10)62590-2
Affiliations:
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<record><TEI wicri:istexFullTextTei="biblStruct"><teiHeader><fileDesc><titleStmt><title>Central nervous system effects of H1-receptor antagonists in the elderly</title><author><name sortKey="Simons, F Estelle R" sort="Simons, F Estelle R" uniqKey="Simons F" first="F Estelle R" last="Simons">F Estelle R. Simons</name></author><author><name sortKey="Fraser, Terry G" sort="Fraser, Terry G" uniqKey="Fraser T" first="Terry G" last="Fraser">Terry G. Fraser</name></author><author><name sortKey="Maher, John" sort="Maher, John" uniqKey="Maher J" first="John" last="Maher">John Maher</name></author><author><name sortKey="Pillay, Neelan" sort="Pillay, Neelan" uniqKey="Pillay N" first="Neelan" last="Pillay">Neelan Pillay</name></author><author><name sortKey="Simons, Keith J" sort="Simons, Keith J" uniqKey="Simons K" first="Keith J" last="Simons">Keith J. 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Simons</name></author><author><name sortKey="Fraser, Terry G" sort="Fraser, Terry G" uniqKey="Fraser T" first="Terry G" last="Fraser">Terry G. Fraser</name></author><author><name sortKey="Maher, John" sort="Maher, John" uniqKey="Maher J" first="John" last="Maher">John Maher</name></author><author><name sortKey="Pillay, Neelan" sort="Pillay, Neelan" uniqKey="Pillay N" first="Neelan" last="Pillay">Neelan Pillay</name></author><author><name sortKey="Simons, Keith J" sort="Simons, Keith J" uniqKey="Simons K" first="Keith J" last="Simons">Keith J. Simons</name></author></analytic><monogr></monogr><series><title level="j">Annals of Allergy, Asthma & Immunology</title><title level="j" type="abbrev">ANAI</title><idno type="ISSN">1081-1206</idno><imprint><publisher>ELSEVIER</publisher><date type="published" when="1999">1999</date><biblScope unit="volume">82</biblScope><biblScope unit="issue">2</biblScope><biblScope unit="page" from="157">157</biblScope><biblScope unit="page" to="160">160</biblScope></imprint><idno type="ISSN">1081-1206</idno></series></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">1081-1206</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="Teeft" xml:lang="en"><term>Additional objective tests</term><term>Adverse effects</term><term>Allergy</term><term>Allergy clin immunol</term><term>Antagonist</term><term>Antihistamines antagonists</term><term>Bartlett test</term><term>Cetirizine</term><term>Chlorpheniramine</term><term>Clin</term><term>Clin pharmacol</term><term>Cognitive</term><term>Cognitive processing</term><term>Crossover study</term><term>Diphenhydramine</term><term>Dosing</term><term>Elderly persons</term><term>Elderly subjects</term><term>Elderly volunteers</term><term>Epicutaneous tests</term><term>Flare areas</term><term>Health sciences</term><term>Histamine</term><term>Histamine phosphate</term><term>Immunol</term><term>Latency</term><term>Loratadine</term><term>Medication</term><term>Nervous system effects</term><term>Placebo</term><term>Predose values</term><term>Psychomotor performance</term><term>Research centre</term><term>Sample size</term><term>Schering canada</term><term>Sedative effects</term><term>Significant difference</term><term>Significant differences</term><term>Somnolence</term><term>Study days</term><term>Study design</term><term>System effects</term><term>System function</term><term>Test time</term><term>Variance</term><term>Visual analog scales</term><term>Visual analogue scale</term><term>Wheal</term><term>Young adults</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract">Background The potential adverse central nervous system effects of H1-receptor antagonists have not been optimally studied in the elderly.Objective We hypothesized that newer H1-receptor antagonists such as cetirizine and loratadine would cause less central nervous system dysfunction than the older H1-receptor antagonists diphenhydramine and chlorpheniramine in this population, as they do in younger subjects.Methods We performed a randomized, double-blind, single-dose, placebo-controlled, 5-way crossover study in 15 healthy elderly subjects (mean age 71 SD 5 years). On study days at least 1 week apart, they received cetirizine 10 mg, loratadine 10 mg, diphenhydramine 50 mg, chlorpheniramine 8 mg, or placebo. Outcome measures, recorded before and 2 to 2.5 hours after dosing were latency of the P300 event-related potential in which increased latency reflects a decreased rate of cognitive processing, visual analogue scale for subjective somnolence, and histamine skin tests for measurement of peripheral H1-blockade.Results The changes in P300 following each treatment yielded variances that were not equal (P > .05), precluding usual statistical analysis of the means. These variances were ranked: chlorpheniramine > diphenhydramine > loratadine > placebo > cetirizine. The rank of mean differences in the visual analogue scale increase from pre-dose baseline was: diphenhydramine > chlorpheniramine > cetirizine > loratadine > placebo. All H1-receptor antagonists suppressed the histamine-induced wheal and flare significantly compared to baseline.Conclusion In the elderly, the new H1-receptor antagonists cetirizine and loratadine are less likely to cause adverse central nervous system effects than the old H1-antagonists chlorpheniramine or diphenhydramine, but this requires confirmation using additional objective tests of central nervous system function.</div></front></TEI><affiliations><list></list><tree><noCountry><name sortKey="Fraser, Terry G" sort="Fraser, Terry G" uniqKey="Fraser T" first="Terry G" last="Fraser">Terry G. Fraser</name><name sortKey="Maher, John" sort="Maher, John" uniqKey="Maher J" first="John" last="Maher">John Maher</name><name sortKey="Pillay, Neelan" sort="Pillay, Neelan" uniqKey="Pillay N" first="Neelan" last="Pillay">Neelan Pillay</name><name sortKey="Simons, F Estelle R" sort="Simons, F Estelle R" uniqKey="Simons F" first="F Estelle R" last="Simons">F Estelle R. Simons</name><name sortKey="Simons, Keith J" sort="Simons, Keith J" uniqKey="Simons K" first="Keith J" last="Simons">Keith J. Simons</name></noCountry></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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