A pilot, open label, clinical trial using hydroxyzine in multiple sclerosis

Area of Science:

• Neuroimmunology
• Demyelinating Diseases

Background:

• Multiple sclerosis (MS) is an autoimmune disease characterized by myelin destruction.
• Blood-brain barrier (BBB) disruption in MS may involve mast cell mediators like histamine.
• Acute stress can trigger MS exacerbations, potentially via mast cell activation.

Purpose of the Study:

• To investigate the efficacy of hydroxyzine, a histamine-1 (H1) receptor antagonist, as an adjuvant therapy for multiple sclerosis.
• To assess the impact of hydroxyzine on neurological symptoms and mood in MS patients.

Main Methods:

• An open-label, pilot clinical trial involving 20 patients with relapsing-remitting or relapsing-progressive MS.
• Patients received oral hydroxyzine (100 mg/day) with caffeine (200 mg/day) for 12 months.
• Disability scales were used for patient evaluation.

Main Results:

• 75% of patients remained neurologically stable or showed improvement.
• Mood improved in all but one patient.
• Hydroxyzine was generally well-tolerated.

Conclusions:

• Hydroxyzine may serve as a beneficial adjuvant therapy for multiple sclerosis.
• Further investigation in a larger, double-blind, placebo-controlled study is warranted due to the pilot nature and small sample size.