Successful treatment of chronic drug-resistant urticaria with alprazolam

Dueñas‐Laita, Antonio; Ruiz-Muñoz, Pedro; Armentia, Alicia; Pinacho, Florentino; Blanca, M.

doi:10.1016/j.jaci.2008.12.005

Cited by 11 publications

(3 citation statements)

References 8 publications

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“…A recent study showed inhibition of the histamine wheal in patients taking alprazolam daily. 8 We evaluated seven patients taking benzodiazepines alone; most had positive histamine skin tests. However, we found that patients taking benzodiazepines along with other potential antihistaminic agents had a 5.01 OR for having a negative histamine control.…”

Section: Discussionmentioning

confidence: 99%

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Predicting which medication classes interfere with allergy skin testing

Shah

Rank²,

Davé³

et al. 2010

allergy asthma proc

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Medications often interfere with allergy skin test interpretation. This study was performed to determine which medications interfere with allergy skin tests. We retrospectively reviewed skin-prick test results from patients who had discontinued H(1)-antagonists, tricyclic antidepressants (TCAs), selective serotonin reuptake inhibitors (SSRIs), selective norepinephrine reuptake inhibitors (SNRIs), benzodiazepines, atypical antidepressants, antipsychotics, hypnotics, sedatives, proton pump inhibitors (PPIs), and H(2)-antagonists between 0 and 7 days before allergy skin testing. Ninety-seven subjects had taken second-generation H(1)-antihistamines within 7 days of skin testing; all patients who had stopped 3 days before testing had positive histamine controls. Two hundred sixty-eight skin tests performed on patients taking a single medication of interest showed that patients had the following percentages of a positive histamine control: TCAs, 56.5%; SNRIs, 100%; H(2)-blockers, 100%; SSRIs, 97%; PPIs, 97%; benzodiazepines, 85.7%; and atypical antidepressants/sedatives, 92.6%. The 580 patients taking multiple medications of interest showed that the odds ratio and 95% confidence intervals of a negative histamine test for patients taking TCAs were 6.33 (2.11-20.5), for H(1)-blockers were 4.95 (1.78-15.1), for benzodiazepines were 5.01 (1.72-15.80), for atypical antidepressants/sedatives were 3.11 (1.09-9.61), and for H(2)-blockers were 2.91 (0.97-9.37). The odds of a negative histamine test for SSRIs, SNRIs, or PPIs were not significantly increased. SSRIs, SNRIs, and PPIs are unlikely to interfere with skin testing. TCAs, H(1)-blockers, benzodiazepines, quetiapine, and mirtazapine should be discontinued temporarily if clinically able. H(2)-antagonists, bupropion, eszopiclone, trazodone, or zolpidem showed minimal interference with immediate hypersensitivity skin test histamine response.

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Section: Discussionmentioning

confidence: 99%

“…Benzodiazepines have been shown antagonize H 1 -and H 2receptors. 8 Histamine is a neurotransmitter that drives wakefulness; therefore, antihistamines are included in sedatives and hypnotics sleep medications. Norepinephrine and serotonin are considered "wake-promoting" neurotransmitters.…”

mentioning

confidence: 99%

Predicting which medication classes interfere with allergy skin testing

Shah

Rank²,

Davé³

et al. 2010

allergy asthma proc

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“…Several classes of medications have not been adequately studied with respect to their effect on allergy skin test responses. Benzodiazepines have been implicated as possibly suppressing skin test responses 1306,1307 . Calcineurin inhibitors demonstrate conflicting findings.…”

Section: Evaluation and Diagnosismentioning

confidence: 99%

International consensus statement on allergy and rhinology: Allergic rhinitis – 2023

Wise

Damask

Roland

et al. 2023

Int Forum Allergy Rhinol

157

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Background In the 5 years that have passed since the publication of the 2018 International Consensus Statement on Allergy and Rhinology: Allergic Rhinitis (ICAR‐Allergic Rhinitis 2018), the literature has expanded substantially. The ICAR‐Allergic Rhinitis 2023 update presents 144 individual topics on allergic rhinitis (AR), expanded by over 40 topics from the 2018 document. Originally presented topics from 2018 have also been reviewed and updated. The executive summary highlights key evidence‐based findings and recommendation from the full document. Methods ICAR‐Allergic Rhinitis 2023 employed established evidence‐based review with recommendation (EBRR) methodology to individually evaluate each topic. Stepwise iterative peer review and consensus was performed for each topic. The final document was then collated and includes the results of this work. Results ICAR‐Allergic Rhinitis 2023 includes 10 major content areas and 144 individual topics related to AR. For a substantial proportion of topics included, an aggregate grade of evidence is presented, which is determined by collating the levels of evidence for each available study identified in the literature. For topics in which a diagnostic or therapeutic intervention is considered, a recommendation summary is presented, which considers the aggregate grade of evidence, benefit, harm, and cost. Conclusion The ICAR‐Allergic Rhinitis 2023 update provides a comprehensive evaluation of AR and the currently available evidence. It is this evidence that contributes to our current knowledge base and recommendations for patient evaluation and treatment.

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International Consensus Statement on Allergy and Rhinology: Allergic Rhinitis

Wise

Lin

Toskala

et al. 2018

Int Forum Allergy Rhinol

339

453

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This critical review of the AR literature has identified several strengths; providers can be confident that treatment decisions are supported by rigorous studies. However, there are also substantial gaps in the AR literature. These knowledge gaps should be viewed as opportunities for improvement, as often the things that we teach and the medicine that we practice are not based on the best quality evidence. This document aims to highlight the strengths and weaknesses of the AR literature to identify areas for future AR research and improved understanding.

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Successful treatment of chronic drug-resistant urticaria with alprazolam

Cited by 11 publications

References 8 publications

Predicting which medication classes interfere with allergy skin testing

Predicting which medication classes interfere with allergy skin testing

International consensus statement on allergy and rhinology: Allergic rhinitis – 2023

International Consensus Statement on Allergy and Rhinology: Allergic Rhinitis

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