A Comparison of Central and Peripheral Effects of Cetirizine and Loratadine

Pechadre, J. C.; Beudin, Patricia; Eschalier, Alain; Trolese, J.F.; Rihoux, J P

doi:10.1177/030006059101900401

Cited by 40 publications

(23 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…20 Other researchers have shown a small increase of P300 latency in cetirizine compared with placebo, but the results were not significant. 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.…”

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%

See 1 more Smart Citation

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

View full text Add to dashboard Cite

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...

show abstract

Section: Discussionmentioning

confidence: 99%

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

View full text Add to dashboard Cite

show abstract

“…On the other hand, several studies have reported slight impairment of some measurements at therapeutic dose [30][31][32][34][35][36], and even the minimal potential of a drug to produce sedation is important, since it might add to or potentiate the sedative effect of another drug or alcohol taken concomitantly. In a previous study carried out in our centre, single oral doses of rupatadine 10 mg in combination with alcohol did not produce more cognitive and psychomotor impairment than alcohol alone [12].…”

Section: Discussionmentioning

confidence: 99%

Rupatadine does not potentiate the CNS depressant effects of lorazepam: randomized, double‐blind, crossover, repeated dose, placebo‐controlled study

García-Gea

Ballester

Martínez

et al. 2010

Brit J Clinical Pharma

View full text Add to dashboard Cite

WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT• Although one defining characteristic of second generation H1-antihistamines is their lack of CNS effects, it has been proved that some compounds of this group are not devoid of such effects.• There is evidence that second generation H1-antihistamine compounds without relevant CNS effects at therapeutic doses could increase the behavioural impairment produced by sedating drugs when both are taken concomitantly.• The evaluation of possible drug interactions is crucial, especially when both compounds could have CNS effects, due to the possible consequences at the patient safety level. WHAT THIS STUDY ADDS• The study demonstrates the lack of CNS effects after repeated administration at therapeutic doses of the unique second generation H1-antihistamine with anti-PAF activity.• The study demonstrates the lack of interaction between repeated administration of rupatadine 10 mg and a single oral dose of lorazepam 2 mg.• The study presents a useful design to evaluate the interaction between two compounds saving time and the exposure of the volunteers to medication. AIMThe main objective was to assess whether benzodiazepine intake when rupatadine plasma concentrations were at steady-state would increase the CNS depressant effects. Rupatadine is a new H1-antihistamine which also inhibits platelet activating factor (PAF) release and has been shown to be clinically effective at doses of 10 mg. METHODSSixteen healthy young volunteers took part in a crossover, randomized, double-blind, placebo controlled trial comprising two experimental periods (repeated administration for 7 days of rupatadine 10 mg or placebo as single oral daily doses, separated by a washout of 14 days). On days 5 and 7, according to a fully balanced design, a single oral dose of lorazepam 2 mg or placebo was added. CNS effects were evaluated on these days by seven objective tests of psychomotor performance and eight subjective visual analogue scales (VAS) at pre-dose and several times after drug intake. Four treatment conditions were evaluated: placebo, rupatadine 10 mg, lorazepam 2 mg and rupatadine 10 mg + lorazepam 2 mg. RESULTSSignificant CNS effects, either impairment of psychomotor performance or subjective sedation, were observed when lorazepam was administered, either alone or in combination with steady state concentrations of rupatadine. No significant differences were found between these two conditions. In addition, rupatadine was not different from placebo. All treatments were well tolerated. CONCLUSIONRepeated doses of rupatadine (10 mg orally) did not enhance the CNS depressant effects of lorazepam (2 mg orally, single dose) either in objective psychomotor tasks or in subjective evaluations.

show abstract

“…18 Subjects were asked to sort out 52 cards depending upon their design. The time taken to sort was noted in seconds as well as the number of correctly sorted and wrongly sorted cards.…”

Section: Measurement Of Critical Flicker Fusion Thresholdmentioning

confidence: 99%

“…16,18,20 This test uses a response sheet containing six letter targets that are distributed among pseudo random letters. The six key letter targets are printed on top of the sheet.…”

Section: Performance Of Six Letter Cancellation Testmentioning

confidence: 99%

Comparative evaluation of H1 receptor blocking activity and safety of newer H1antagonist mizolastine with loratadine and placebo: a randomized double blind three way crossover study

Swarnalatha

Sonia

Reddy³

et al. 2016

Int J Basic Clin Pharmacol

View full text Add to dashboard Cite

A Comparison of Central and Peripheral Effects of Cetirizine and Loratadine

Cited by 40 publications

References 8 publications

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

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

Rupatadine does not potentiate the CNS depressant effects of lorazepam: randomized, double‐blind, crossover, repeated dose, placebo‐controlled study

Comparative evaluation of H1 receptor blocking activity and safety of newer H1antagonist mizolastine with loratadine and placebo: a randomized double blind three way crossover study

Contact Info

Product

Resources

About