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Hydroxyzine Use in Preschool Children and Its Effect on Neurodevelopment: A Population-Based Longitudinal Study
Hans J Gober1,2, Kathy H Li3,4, Kevin Yan1
1Division of Translational Therapeutics, Department of Pediatrics, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.
First-generation antihistamine hydroxyzine use in young children was linked to higher rates of mental and psychomotor disorders, including tics and anxiety, up to age 10. Further research is needed to confirm causality and hydroxyzine safety in pediatric populations.
Area of Science:
- Pediatric pharmacology
- Neurodevelopmental disorders
- Pharmacovigilance
Background:
- First-generation antihistamines like hydroxyzine are frequently prescribed to children under 5.
- While effective for pruritus, histamine receptor antagonism may impact psychomotor behavior.
- Concerns exist regarding the long-term neurodevelopmental safety of early hydroxyzine exposure.
Purpose of the Study:
- To investigate the longitudinal patterns of hydroxyzine use in young children.
- To determine the association between early hydroxyzine exposure and mental/psychomotor disorders up to age 10.
- To assess the safety profile of hydroxyzine in the pediatric population.
Main Methods:
- Retrospective cohort study using prescription data from British Columbia, Canada.
- Analysis of International Classification of Diseases (ICD-9/10) codes for mental and psychomotor disorders.
- Comparison of disorder rates between frequent and single hydroxyzine users.
Main Results:
- Frequent hydroxyzine users showed significantly higher rates of tics (OR 1.55), anxiety (OR 1.34), and conduct disturbance (OR 1.34).
- A non-significant trend towards increased ADHD and emotional disturbance was observed.
- This is the first study to report a potential association between early hydroxyzine use and adverse neurodevelopmental effects.
Conclusions:
- Early and frequent use of hydroxyzine in children under 5 is associated with an increased risk of certain neurodevelopmental disorders.
- Controlled studies are necessary to establish a causal relationship.
- Shortest possible duration of hydroxyzine use is recommended for preschool-aged children pending further evidence.
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