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Antihistamines: the old and the new
J F Peggs1, L A Shimp, R A Opdycke
1Department of Family Practice, University of Michigan Medical School, Ann Arbor, USA.
American Family Physician
|August 1, 1995
Summary
Newer antihistamines offer improved H1 receptor selectivity, reducing side effects like sedation compared to classic agents. Both types effectively treat histamine-mediated symptoms, with newer options suitable for sensitive patients.
Area of Science:
- Pharmacology
- Allergy & Immunology
Background:
- Antihistamines act on H1 histamine receptors.
- Classic agents are nonselective, causing various side effects.
- Newer agents selectively block peripheral H1 receptors, reducing side effects.
Purpose of the Study:
- To review the therapeutic uses and side effect profiles of classic and newer antihistamines.
- To guide the selection of antihistamines based on efficacy, cost, and side effect minimization.
Main Methods:
- Review of pharmacologic agents targeting H1 histamine receptors.
- Comparison of selectivity, side effect profiles, and therapeutic applications.
- Analysis of cost-effectiveness and patient tolerability.
Main Results:
- Newer antihistamines exhibit preferential peripheral H1 receptor blockade, leading to fewer side effects, notably sedation.
- Antihistamines are effective for allergic conditions, insomnia, nausea, and respiratory symptoms.
- Classic antihistamines are cost-effective for histamine-mediated symptoms, with CNS effects manageable by bedtime dosing.
Conclusions:
- Antihistamine selection should balance cost, efficacy, and side effect profiles.
- Nonsedating antihistamines provide an alternative for patients intolerant to classic agents.
- Both classic and newer antihistamines remain valuable therapeutic options.