 |
|
Initial and Steady-State Effects of Diphenhydramine and Loratadine on Sedation, Cognition, Mood, and Psychomotor Performance
Gary G. Kay, PhD;
Brian Berman, MD, PhD;
Sandra H. Mockoviak;
Christine Eberle Morris;
Dennis Reeves, PhD;
Victoria Starbuck, PhD;
Elizabeth Sukenik, MD;
Alan G. Harris, MD
Arch Intern Med. 1997;157(20):2350-2356.
Abstract
| |
Background
The classic, first-generation histamine1-receptor antagonists used to treat allergic disorders frequently cause sedation. In contrast, sedation is reduced or absent after administration of recommended doses of second-generation histamine1-receptor antagonists. We measured the initial and steady-state effects of diphenhydramine, a first-generation antihistamine, and lorata-dine, a second-generation antihistamine, by means of a comprehensive battery of psychometric tests that mirror real-world tasks.
Methods
Healthy volunteers (N=98) were randomly assigned in a double-blind fashion to receive loratadine (n=33), diphenhydramine (n=32), or placebo (n=33). A computerized test battery was administered at baseline, on day 1 after administration of the initial dose, and on days 3 and 5.
Results
After the initial dose, subjects taking diphenhydramine demonstrated poorer cognitive performance than subjects taking loratadine or placebo on tasks of divided attention, working memory, speed, and vigilance. Subjects taking diphenhydramine also reported greater fatigue and sleepiness and lower levels of motivation, and rated the quality of their performance as lower than subjects taking loratadine or placebo. On day 3, subjects taking diphenhydramine continued to show more fatigue and lower motivation, and rated the quality of their test performance as poorer than subjects taking loratadine or placebo. There were no differences between loratadine and placebo after the initial dose or steady-state (day 5) dosing for any measure of cognitive or psychomotor test performance, mood, or sedation.
Conclusions
Patients taking diphenhydramine may be at risk of lapses and significant errors that may lead to potential hazards and decreased work productivity.
Arch Intern Med. 1997;157:2350-2356
Author Affiliations
From the Department of Neurology, Georgetown University School of Medicine, Washington, DC (Drs Kay and Starbuck and Ms Morris); Department of Dermatology and Cutaneous Surgery, University of Miami School of Medicine, Miami, Fla (Drs Berman and Sukenik); Phase IV Research Unit, Schering-Plough Corp, Kenilworth, NJ (Ms Mockoviak and Dr Harris); and National Cognitive Recovery Foundation, San Diego, Calif (Dr Reeves).
 CiteULike  Connotea  Del.icio.us  Digg  Reddit  Technorati  Twitter
What's this?
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
|
Neuropsychological Performance in Persons With Chronic Fatigue Syndrome: Results From a Population-Based Study
Majer et al.
Psychosom. Med. 2008;70:829-836.
ABSTRACT
| FULL TEXT
Neurocognitive Costs and Benefits of Psychotropic Medications in Older Adults
Brooks and Hoblyn
J Geriatr Psychiatry Neurol 2007;20:199-214.
ABSTRACT
Advances in H1-Antihistamines
Simons
NEJM 2004;351:2203-2217.
FULL TEXT
Therapeutic and Economic Consequences of OTC Loratadine
Nair and Sullivan
The Annals of Pharmacotherapy 2004;38:169-171.
FULL TEXT
Inappropriate Medications for Elderly Patients
Chutka et al.
Mayo Clin Proc. 2004;79:122-139.
ABSTRACT
Are Second-Generation Antihistamines Appropriate for Most Children and Adults?
Haydon III
Arch Otolaryngol Head Neck Surg 2001;127:1510-1514.
FULL TEXT
Evaluation of the Interaction of Loratadine and desloratadine with P-glycoprotein
Wang et al.
Drug Metab. Dispos. 2001;29:1080-1083.
ABSTRACT
| FULL TEXT
First-Generation vs Second-Generation Antihistamines
Aelony and Kay
Arch Intern Med 1998;158:1949-1950.
FULL TEXT
|
