Chlorpheniramine Is No More Effective than Placebo in Relieving the Symptoms of Childhood Atopic Dermatitis with a Nocturnal Itching and Scratching Component

Abstract

Background: Childhood atopic dermatitis (AD) is a common disorder affecting 15% of children aged over 18 months. AD is associated with intense nocturnal itching. The central sedative effect of antihistamines is thought to be useful in interrupting the itching cycle and may prevent exacerbations. Objective: A multi-centred, double-blind, placebo-controlled study was carried out in 155 children to evaluate chlorpheniramine in alleviating symptoms of AD. Methods: Assessments were carried out over a 4-week study period consisting of 3 visits to out-patient clinics. During the visits the severity of AD and itching was rated using a series of visual analogue scale (VAS) and 5-point rating scales. Results: The use of chlorpheniramine resulted in no greater alleviation of AD symptoms than placebo. Conclusions: The findings contradict conventional wisdom that the sedative effect of earlier-generation antihistamines alleviates symptoms of AD. The study also indicates that the use of antihistamines in AD does not affect the amounts of topical treatment used over the short term.

Antihistamines in the Treatment of Atopic Dermatitis

“…[33][34][35] Furthermore, Nuovo et al 35 emphasize in their discussion that it is inappropriate to generalize results from a single-patient randomized clinical trial about treatment effects for other patients with the same condition.…”

Effect of 2,3,7,8-tetrachlorodibenzo-p-dioxin on scratching behavior in mice

“…After repeated administration for one week, chlorpheniramine and tranilast had no significant effect. Even in clinical findings, chlorpheniramine and tranilast are regarded as ineffective against the itching and scratching of itchy skin [27]. On the other hand, as shown in the text, repeated administration of olopatadine significantly inhibited scratching behavior.…”

Synergetic Effects of Prednisolone and Olopatadine on Atopic Dermatitis Model of Hairless Mice

“…On the other hand, different from chlorpheniramine, olopatadine showed a significant ef- fect on scratching behavior, but not skin symptoms, when used repeatedly. In clinical settings, chlorpheniramine is regarded as ineffective against itching and/or scratching in atopic dermatitis patients [17] . On the other hand, olopatadine decreased the production of various cytokines, and tachykinin and chemical mediator release had inhibitory effects [18][19][20][21] .…”