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• W2091978480 abstract "Histamine H1 receptor antagonists (antihistamines), used for the treatment of allergic disorders, often induce sedative side effects in patients. Such sedative side effects are potentially dangerous because they sometimes result in serious accidents among people who drive cars, operate aircrafts or heavy machinery. Recent drug development has produced various new generation antihistamines with potent anti-allergic effects but with limited sedation. It has become important to evaluate sedative properties of different antihistamines. In general, the limited sedative property results from limited permeability of blood-brain barrier. To measure the sedative property, various methods have been introduced such as measurement of subjective sleepiness, objective computer cognitive tests, actual car driving tests, measurement of cerebral histamine H1 receptor blockade with positron emission tomography (PET), etc. The present study compared sedative properties of a classical antihistamine (hydroxyzine), and of two different second-generation antihistamines, fexofenadine and cetirizine, in healthy Japanese volunteers, using the following measurements: (1) subjective sleepiness; (2) computer-based psychomotor tests; (3) brake reaction time (BRT) during actual car driving, with and without talking on a cellular phone; and (4) brain histamine H1R occupancy (H1RO) using PET with [11C]doxepin, a potent radioligand for histamine H1 receptors. Subjects were administered a single dose of fexofenadine 120 mg or cetirizine 20 mg in a double-blind, placebo-controlled, crossover design. Hydroxyzine 30 mg was included as a positive control. Subjective sleepiness, psychomotor performance (n=20) and H1RO with PET (n=12) were measured at baseline and 90 min post-dose. The car driving test (n=18) was conducted at baseline, and at 90 and 240 min post-dose. In results, fexofenadine was not significantly different from placebo for subjective sleepiness and computer-based psychomotor tests, and was significantly less impairing than cetirizine on some measurements (p 50%). In summary, the assessments had the following sensitivity to differentiate between the sedative profiles of antihistamines: H1RO with PET > psychomotor test > BRT with phone = sleepiness > BRT without phone. Fexofenadine 120 mg demonstrated a non-sedative profile and could be differentiated from cetirizine 20 mg. Drivers administered hydroxyzine were slower at recognizing hazards ahead and applying the brake compared with subjects given fexofenadine or placebo. Importantly, cellular phone operation was an additive factor, increasing BRTs in subjects given hydroxyzine. In contrast, fexofenadine did not impair CNS function in subjects involved in a divided attention task of driving and cellular phone operation." @default.
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• W2091978480 date "2005-08-01" @default.
• W2091978480 modified "2023-09-27" @default.
• W2091978480 title "Sedative profiles of antihistamine drugs evaluated by subjective sleepiness, cognitive tests, and PET for measurement of cerebral histamine H1 receptor occupancy" @default.
• W2091978480 doi "https://doi.org/10.1038/sj.jcbfm.9591524.0416" @default.
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