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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 14 of 14. This is the beginning of the thread.
Posted by tensor on October 3, 2006, at 10:22:46
This is something that i've asked before but never got a satisfying answer to. I read in my book of psychopharmacology that an antihistamine can be prescribed for itching allergic rash that has developed due to Lamictal. For instance the antihistamine Atarax(hydroxyzine) which is an H1 antagonist.
I take Remeron which also happens to be a strong antihistamine, H1 antagonist, does remeron have the same effect as Atarax against itching rash? If not, why?/Mattias
Posted by SLS on October 3, 2006, at 11:04:16
In reply to Antihistamine, posted by tensor on October 3, 2006, at 10:22:46
> This is something that i've asked before but never got a satisfying answer to. I read in my book of psychopharmacology that an antihistamine can be prescribed for itching allergic rash that has developed due to Lamictal. For instance the antihistamine Atarax(hydroxyzine) which is an H1 antagonist.
> I take Remeron which also happens to be a strong antihistamine, H1 antagonist, does remeron have the same effect as Atarax against itching rash? If not, why?
Remeron is used to treat pruritis, from what I could gather doing a Google search. However, I have often wondered the same thing you have about drugs like Remeron and Sinequan. What is it about them that has prevented them from becoming known as effective antihistamines? I haven't looked into their differential pharmacology. Maybe there are subtypes of the H1 receptor. I don't really know.
- Scott
Posted by Phillipa on October 3, 2006, at 11:04:37
In reply to Antihistamine, posted by tensor on October 3, 2006, at 10:22:46
If the rash is from lamictal it could be Stevens Johnson' which is dangerous call your doc. Love Phillipa
Posted by tensor on October 3, 2006, at 11:10:49
In reply to Re: Antihistamine » tensor, posted by Phillipa on October 3, 2006, at 11:04:37
> If the rash is from lamictal it could be Stevens Johnson' which is dangerous call your doc. Love Phillipa
I don't have rash. Not yet anyway :-) I am just curious.
Posted by tensor on October 3, 2006, at 11:20:34
In reply to Re: Antihistamine, posted by SLS on October 3, 2006, at 11:04:16
>What is it about them that has prevented them from becoming known as effective antihistamines?
Maybe because it isn't as selective as Atarax, but on the other hand there seems to be other mechanisms involved. From Medscape:
The oral antidepressant mirtazapine relieves itch in some patients (Davis, Frandsen, Walsh, Andresen, & Taylor, 2003; Hundley & Yosipovitch, 2004). We have successfully alleviated nighttime itching in many patients using a low dose of 15 milligrams at night (Hundley & Yosipovitch, 2004). This mirtazapine regimen is effective even in cases of severe pruritus associated with erythrodermic psoriasis. Mirtazapine has a sedative effect due to its H1-antihistamine properties, but it also acts as an antagonist at noradrenergenic α2-receptors and 5HT2 and 5HT3 serotonin receptors. Therefore, it enhances the release of norepinephrine and selectively increases serotonin transmission. It is not clear which mechanism of action is responsible for mirtazapine's anti pruritic properties; the α2-adrenergic antagonism may act to centrally reduce itch. Other common antidepressants like fluoxetine, citalopram, sertraline, and paroxetine do not appear to be effective for itch.It's not used only for its antihistamine properties, well i'm sure you found the same article.
/Mattias
Posted by naughtypuppy on October 3, 2006, at 12:28:56
In reply to Re: Antihistamine » SLS, posted by tensor on October 3, 2006, at 11:20:34
Maybe it's just because they are known primarly as antidepressants and doctors are reluctant to use them because of that.
Posted by Meri-Tuuli on October 3, 2006, at 12:54:18
In reply to Re: Antihistamine, posted by naughtypuppy on October 3, 2006, at 12:28:56
> Maybe it's just because they are known primarly as antidepressants and doctors are reluctant to use them because of that.
and also because they aren't FDA approved (or whatever) so insurance won't pay the expense it costs to prescribe them 'off-labal'. That and most of the doctors probably don't know!
Posted by notfred on October 3, 2006, at 12:56:09
In reply to Re: Antihistamine, posted by SLS on October 3, 2006, at 11:04:16
> Remeron is used to treat pruritis, from what I could gather doing a Google search. However, I have often wondered the same thing you have about drugs like Remeron and Sinequan. What is it about them that has prevented them from becoming known as effective antihistamines? I haven't looked into their differential pharmacology. Maybe there are subtypes of the H1 receptor. I don't really know.
>
>
> - ScottIt does not seem to be very effective, I have had allergy tests while on Remeron and an injection of
histamine as control (vs injection of saline) still produces a normal reaction, a large welt. OTOH, an injection of histamine while on Doxipin produces no recation.
Posted by psychobot5000 on October 3, 2006, at 14:55:09
In reply to Re: Antihistamine, posted by SLS on October 3, 2006, at 11:04:16
Doxepin/Sinequan is actually the most effective antihistamine known to man. The reason it's not used much is because of all the tricyclic side-effects. For example, you can only smear the ointment on so much of your body, before you must worry about absorbing too much internally, and getting tachycardia (from antimuscarinic effects) and heavy sedation.
Also, it has the commercial disadvantage of being old and cheap.
As for Remeron, I don't think clinicians and researchers consider it as powerful an antihistamine as some others (I have read words to this effect), despite the powerful sedative and appetite stimulant effects that indicate otherwise. ...But it also has more side-effects than, say, benadryl.
But seriously, if you have a rash (that's doesn't cover too much body area), doxepin/sinequan is the strongest and best remedy.
P-bot
>
>
> Remeron is used to treat pruritis, from what I could gather doing a Google search. However, I have often wondered the same thing you have about drugs like Remeron and Sinequan. What is it about them that has prevented them from becoming known as effective antihistamines? I haven't looked into their differential pharmacology. Maybe there are subtypes of the H1 receptor. I don't really know.
>
>
> - Scott
>
Posted by tensor on October 3, 2006, at 14:58:55
In reply to Re: Antihistamine, posted by psychobot5000 on October 3, 2006, at 14:55:09
Posted by ed_uk on October 3, 2006, at 15:51:31
In reply to Re: Antihistamine, posted by SLS on October 3, 2006, at 11:04:16
>I have often wondered the same thing you have about drugs like Remeron and Sinequan. What is it about them that has prevented them from becoming known as effective antihistamines?
Marketing. They are marketed as ADs. Besides, non-sedating antihistamines are all the rage thesedays.
Ed
Posted by notfred on October 3, 2006, at 16:45:17
In reply to Re: Antihistamine, posted by psychobot5000 on October 3, 2006, at 14:55:09
>
> But seriously, if you have a rash (that's doesn't cover too much body area), doxepin/sinequan is the strongest and best remedy.
>
Yep. My allergist calls Doxipin his secret weapon
for hives and rashes. It is the most powerful antihistamine I have ever taken, & I have taken them all.
Posted by yxibow on October 3, 2006, at 18:15:10
In reply to Re: Antihistamine, posted by notfred on October 3, 2006, at 16:45:17
My mother has angioedema and takes doxepin for H1 and Zantac for H2
Posted by Phillipa on October 3, 2006, at 19:55:15
In reply to Re: Antihistamine » SLS, posted by tensor on October 3, 2006, at 11:20:34
Wow!!!!! That time they gave me seroquel in the hospital they also gave me remeron to sleep didn't work naturally. But a week after coming off the seroquel my face puckered up and my lips were peeling could it be that it wasn't from coming off seroquel but from still being on remeron l5mg? Love Phillipa
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