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TOPLINE:
First-generation antihistamines are linked to a 22% greater threat for seizures in youngsters, new analysis exhibits. The chance seems to be most pronounced in youngsters aged 6-24 months.
METHODOLOGY:
- Researchers in Korea used a self-controlled case-crossover design to evaluate the chance for seizures related to prescriptions of first-generation antihistamines.
- They analyzed information from 11,729 youngsters who had a seizure occasion (an emergency division go to with a prognosis of epilepsy, standing epilepticus, or convulsion) and had beforehand acquired a prescription for a first-generation antihistamine, together with chlorpheniramine maleate, mequitazine, oxatomide, piprinhydrinate, or hydroxyzine hydrochloride.
- Prescriptions in the course of the 15 days earlier than a seizure had been thought of to have been acquired throughout a hazard interval, whereas earlier prescriptions had been thought of to have been acquired throughout a management interval.
- The researchers excluded sufferers with febrile seizures.
TAKEAWAY:
- In an adjusted evaluation, a prescription for an antihistamine in the course of the hazard interval was related to a 22% greater threat for seizures in youngsters (adjusted odds ratio, 1.22; 95% CI, 1.13-1.31).
- The seizure threat was vital in youngsters aged 6-24 months, with an adjusted odds ratio of 1.49 (95% CI, 1.31-1.70).
- For older youngsters, the chance was not statistically vital.
IN PRACTICE:
“The research underscores a considerable improve in seizure threat related to antihistamine prescription amongst youngsters aged 6 to 24 months,” the authors of the research wrote. “We aren’t conscious of every other research which have identified the elevated threat of seizures with first-generation antihistamines on this specific age group….The advantages and dangers of antihistamine use ought to at all times be fastidiously thought of, particularly when prescribing H1 antihistamines to weak infants.”
The findings elevate a number of questions for clinicians, together with how a “comparatively small threat” ought to translate into follow, and whether or not the chance could also be attenuated with newer antihistamines, wrote Frank Max Charles Besag, MB, ChB, with East London NHS Basis Belief, in London, England, in an editorial accompanying the study. “It will be cheap to tell households that no less than 1 research has recommended a comparatively small improve within the threat of seizures with first-generation antihistamines, including that there are nonetheless too few information to attract any agency conclusions and in addition offering households with the data on what to do if the kid had been to have a seizure.”
SOURCE:
Seonkyeong Rhie, MD, and Man Yong Han, MD, each with the Division of Pediatrics at CHA College College of Drugs, in Seongnam, South Korea, had been the corresponding authors on the research. The analysis was published online on August 28, 2024, in JAMA Community Open.
LIMITATIONS:
The researchers didn’t have particulars about seizure signs, didn’t embrace youngsters seen in outpatient clinics, and had been unable to confirm the precise consumption of the prescribed antihistamines. Though second-generation antihistamines could also be much less more likely to cross the blood-brain barrier, one newer medicine, desloratadine, has been related to seizures.
DISCLOSURES:
The research was supported by grants from the Korea Well being Expertise R&D Undertaking via the Korea Well being Trade Growth Institute, the Ministry of Well being and Welfare, Republic of Korea.
This text was created utilizing a number of editorial instruments, together with AI, as a part of the method. Human editors reviewed this content material earlier than publication.
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