Sleepiness and performance during three-day administration of cetirizine or diphenhydramine

Schweitzer, Paula K.; Muehlbach, Mark J.; Welsh, James K.

doi:10.1016/0091-6749(94)90179-1

Cited by 70 publications

(33 citation statements)

References 18 publications

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“…Same numbers indicate same subjects (open circles men, closed circles women). The equivalence limits (2.6 cm; + 2.6 cm) are indicated by dashed lines chronic use has been previously reported by other behavioral studies (Schweitzer et al 1994;Kay et al 1997). However, we agree that tolerance lasts only as long as therapy is continued (Schweitzer et al 1994;Nolen 1997) and, since antihistamines are often used only if needed, performance impairment will reappear each time therapy is initiated.…”

Section: Diphenhydraminementioning

confidence: 66%

Driving ability after acute and sub-chronic administration of levocetirizine and diphenhydramine: a randomized, double-blind, placebo-controlled trial

et al. 2003

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Section: Diphenhydraminementioning

confidence: 66%

Driving ability after acute and sub-chronic administration of levocetirizine and diphenhydramine: a randomized, double-blind, placebo-controlled trial

et al. 2003

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“…21,22 Cetirizine 10 mg was completely devoid of electroencephalogram changes in most studies, 14,17 although at least 1 report 26 showed otherwise. Studies using driving simulators, 12,27 multiple sleep latency, 18,19 and psychomotor tests 12-14 also showed that cetirizine had no CNS effects. Conversely, 1 study reported significantly impaired driving performance with cetirizine 10 mg. 28 Another showed significant differences in psychomotor tests between cetirizine and placebo 15 ; however, there was no positive control in the latter study.…”

Section: Discussionmentioning

confidence: 99%

“…Also, cetirizine overdose in children is more likely to cause sedation than overdose with the other second-generation antihistamines. 10,11 Numerous studies in the literature have investi-gated the sedative effects of cetirizine in adults using psychometric tests, [12][13][14][15] simulated driving, 12,15 electroencephalograms, 16,17 multiple sleep latency tests, 18,19 and P300 evoked potential. 20 -22 Most conclude that cetirizine has no CNS effects.…”

mentioning

confidence: 99%

Central Nervous System Side Effects of First- and Second-Generation Antihistamines in School Children With Perennial Allergic Rhinitis: A Randomized, Double-Blind, Placebo-Controlled Comparative Study

Chong

Wong

et al. 2004

Pediatrics

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ABSTRACT. Objective. Allergic rhinitis is common and on the rise. Antihistamines are the mainstay of treatment and are the most commonly prescribed drugs in Singapore. Treatment-related sedation and its effect on cognition are a major concern. First-and second-generation antihistamines show varying degrees of sedation, but to date, objective studies in children are lacking. The objective of this study was to assess the sedating effect of cetirizine (second-generation antihistamine) and chlorpheniramine (first-generation antihistamine) compared with placebo using an objective neurophysiological test.Methods. This was a prospective, double-blind, placebo-controlled, randomized, single-dose, 3-way crossover study. Twenty-four children aged 7 to 14 years with allergic rhinitis completed the study. All children were randomly allocated to medication sequences and received 3 different drugs on 3 different days, at least 1 week apart. The P300 event-related potential was used as an objective test of sedation. Subjective assessment was by a visual analog scale.Results. Chlorpheniramine and cetirizine increased P300 latency when compared with baseline. No significant increase was obtained with placebo. The significant increase in P300 latency was not accompanied by significant change in subjective somnolence as measured by the visual analog scale.Conclusion. We have shown that cetirizine has sedative properties in children. The lack of correlation between P300 latency and the visual analog scale indicates that sedation induced by these drugs may not be subjectively noted. Pediatrics 2004;113:e116 -e121. URL: http: //www.pediatrics.org/cgi/content/full/113/2/e116; sedation, cetirizine, chlorpheniramine, P300 event-related potential.ABBREVIATIONS. CNS, central nervous system; ERP, event-related potential; VAS, visual analog scale; Fz , frontal location; Cz, central location; Pz, parietal location; T max , time to peak plasma drug concentration.A llergic rhinitis is on the increase worldwide as well as in Singapore. A 1994 survey showed the prevalence of rhinitis in Singapore children to be at a staggering 44%. 1 In children with allergic rhinitis, inadequate symptom control may contribute to learning impairment; school absences; poor quality of life; and emotional, social, or behavioral disturbances. 2 Oral antihistamines are the mainstay of therapy for allergic rhinitis in children 3 and have been used effectively for managing symptoms of allergic rhinitis for Ͼ50 years. They are the most commonly prescribed drugs among outpatient doctors in the public service in Singapore. 4 The major limitation of the use of first-generation antihistamines is sedation. 3 Being lipophilic molecules, they easily cross the blood-brain barrier and may exacerbate the decrease in cognitive function already experienced by the patient with allergic rhinitis. Sedating antihistamines have been shown to reduce learning performance in children. 5 In contrast, second-generation antihistamines are relatively lipophobic and therefore cross the blood-br...

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“…When alertness is high, participants may perform well because of motivation and familiarity with the task [13]. However, after 30 minutes of uneventful driving (with or without drugs), drivers begin to lose interest in the task at hand.…”

Section: Standard Dutch Testmentioning

confidence: 96%

“…One ingenious performance testing scenario has been introduced by Walsh et al [9,13]. It is known as the simulated assembly line task (SALT), and functions as a complex divided attention task.…”

Section: Simulated Assembly-line Taskmentioning

confidence: 99%

Sedation, cognition, and antihistamines

Qidwai

Watson

Weiler

2002

Curr Allergy Asthma Rep

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First-generation antihistamines are well-known to cause subjective drowsiness. A myriad of studies has also been published that suggest a clear relationship between the use of these drugs and objective performance impairment. Although not all of the tests used in these studies have been validated, the data are fairly consistent, and suggest a difference between earlier (first-generation) sedating antihistamines and the newer (second-generation) nonsedating antihistamines.

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Sleepiness and performance during three-day administration of cetirizine or diphenhydramine

Cited by 70 publications

References 18 publications

Driving ability after acute and sub-chronic administration of levocetirizine and diphenhydramine: a randomized, double-blind, placebo-controlled trial

Driving ability after acute and sub-chronic administration of levocetirizine and diphenhydramine: a randomized, double-blind, placebo-controlled trial

Central Nervous System Side Effects of First- and Second-Generation Antihistamines in School Children With Perennial Allergic Rhinitis: A Randomized, Double-Blind, Placebo-Controlled Comparative Study

Sedation, cognition, and antihistamines

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