Use of Cetirizine in a 23-Month-Old Male Causes Insomnia

Abstract

Allergic rhinitis affects approximately 40% of children and generally presents in children from 10-19 years of age; however, the condition has been seen in children as young as 6 months. Antihistamines are commonly prescribed in infants and children for the relief of allergic symptoms. A 23-month-old male with a history of chronic otitis media was prescribed cetirizine 2.5 mg daily at bedtime for maintenance of his chronic rhinitis symptoms. Several days into therapy, the child began experiencing frequent and progressive nighttime periods of awakening. Once treatment was discontinued, the child resumed his normal sleeping patterns.

A case report of sleep terrors exacerbated by cetirizine

“…Cetirizine is a second-generation antihistamine that crosses the blood-brain barrier, has been previously associated with insomnia and nocturnal awakenings, and can cause tolerance with long-term use. 9 Cetirizine has very rarely been associated with either the onset or exacerbation of sleep terrors. In 1 previous case report, a 4-year-old patient with a 2-year history of sleep terrors had complete resolution of the sleep terrors after discontinuation of cetirizine and subsequent recurrence of sleep terrors after another reintroduction of cetirizine.…”