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Histamine and Delirium: Current Opinion.

Paul L Chazot1, Laura Johnston1, Edel Mcauley2

  • 1Department of Biosciences, Durham University, Durham, United Kingdom.

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Summary

Delirium, a common condition in the elderly and intensive care, involves fluctuating cognitive and behavioral changes. Histamine H3 receptor antagonists may offer a novel therapeutic strategy to combat delirium symptoms.

Keywords:
CNSH3 receptorautoreceptordeliriumheteroreceptorhistamine

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Area of Science:

  • Neuroscience
  • Pharmacology
  • Geriatrics

Background:

  • Delirium is a frequent and challenging clinical condition, particularly in intensive care units and among the elderly population.
  • It manifests as fluctuating disturbances in cognition, mood, attention, arousal, and self-awareness.
  • Histamine, a highly versatile neurotransmitter in the human brain, is implicated in modulating these key features.

Purpose of the Study:

  • To review the role of histamine in delirium.
  • To propose histamine receptor antagonists as a potential therapeutic strategy for delirium.
  • To explore the involvement of histamine H4 receptors in neuroinflammation related to delirium.

Main Methods:

  • Literature review and theoretical analysis of histamine's role in neurotransmission.
  • Examination of the effects of histamine receptor antagonists on delirium.
  • Discussion of potential neuroinflammatory mechanisms involving histamine H4 receptors.

Main Results:

  • Centrally acting H1 and H2 histamine receptor antagonists may exacerbate delirium.
  • Centrally acting H3 histamine receptor antagonists show promise as a novel treatment for delirium.
  • The histamine H4 receptor's indirect inflammatory neuroglial role in delirium warrants further investigation.

Conclusions:

  • Histamine neurotransmission is a key modulator of delirium symptoms.
  • Targeting histamine H3 receptors presents a promising new avenue for delirium pharmacotherapy.
  • Further research into histamine H4 receptor involvement in neuroinflammation is needed.