Abstract | BACKGROUND: Many physicians believe that the most effective way to treat chronic urticaria is to take a nonsedating second-generation H1 - antihistamine in the morning and a sedating first-generation H1 - antihistamine, usually hydroxyzine, at night to enhance sleep. But is this belief well founded? OBJECTIVES: METHODS: RESULTS: Both treatments significantly decreased UAS, night-time sleep disturbances and CU-Q2 oL scores (P < 0·001) without significant differences between the two. Compared with baseline, daytime somnolence was significantly reduced by levocetirizine monotherapy (P = 0·006) but not by levocetirizine plus hydroxyzine (P = 0·218). Direct comparison of the two treatment modalities in terms of daytime somnolence favoured levocetirizine monotherapy (P = 0·026). CONCLUSIONS: The widespread belief that sleep is aided by the addition of a sedating first-generation H1 - antihistamine, usually hydroxyzine, at night is not supported. These results are in line with the urticaria guidelines, which state that first-line treatment for urticaria should be new-generation, nonsedating H1 - antihistamines only.
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Authors | M Staevska, M Gugutkova, C Lazarova, T Kralimarkova, V Dimitrov, T Zuberbier, M K Church, T A Popov |
Journal | The British journal of dermatology
(Br J Dermatol)
Vol. 171
Issue 1
Pg. 148-54
(Jul 2014)
ISSN: 1365-2133 [Electronic] England |
PMID | 24472058
(Publication Type: Comparative Study, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
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Copyright | © 2014 The Authors. British Association of Dermatology published by John Wiley & Sons Ltd on behalf of British Association of Dermatologists. |
Chemical References |
- Histamine H1 Antagonists
- Histamine H1 Antagonists, Non-Sedating
- Hydroxyzine
- levocetirizine
- Cetirizine
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Topics |
- Adult
- Aged
- Cetirizine
(administration & dosage, adverse effects)
- Chronic Disease
- Cross-Over Studies
- Double-Blind Method
- Drug Administration Schedule
- Drug Therapy, Combination
- Female
- Histamine H1 Antagonists
(administration & dosage, adverse effects)
- Histamine H1 Antagonists, Non-Sedating
(administration & dosage, adverse effects)
- Humans
- Hydroxyzine
(administration & dosage, adverse effects)
- Male
- Middle Aged
- Patient Selection
- Quality of Life
- Sleep Wake Disorders
(chemically induced)
- Treatment Outcome
- Urticaria
(drug therapy)
- Young Adult
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