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J Montoro1, J Bartra2,
J Sastre3, I Dávila4, M Ferrer5,
J Mullol6, A del Cuvillo7, I
Jáuregui8, A Valero2 |
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1Allergy Unit, Arnau de
Vilanova University Hospital, Faculty of Medicine,
Catholic University of Valencia "San Vicente Mártir",
Valencia, Spain
2Allergy Unit, Pneumology and Respiratory
Allergy Department, Hospital Clínic (ICT), Barcelona,
Spain
3Allergy Department, Jiménez Diaz Foundation,
Madrid, Spain
4Immunoallergy Department, Salamanca
University Welfare Complex, IBSAL, Salamanca, Spain
5Allergology Department, Navarra University
Clinic, Pamplona, Spain
6Rhinology Unit and Olfactory Clinic,
Otorhinolaryngology Department, Hospital Clínic (ICT),
Barcelona, Spain
7Dr. Lobatón Clinic, Cadiz, Spain
8Allergy Department, Basurto University
Hospital, Bilbao, Spain |
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Abstract |
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Antihistamines (AH)
have been classified
into first and
second generation
according to their
pharmacokinetic
properties,
structural
characteristics and
adverse effects. The
effects on the
central nervous
system (CNS) are
determined basically
by their capacity to
cross the
hematoencephalic
barrier and attach
to central H1
receptors.
Benzodiazepines (BZD)
are drugs with
effects on the CNS
following their
union to the
specific location of
GABA receptors type
A. At low doses, the
BZD have sedative
and anticonvulsive
effects, and as the
dose increases it
leads to sedation,
amnesia and finally
unconsciousness.
Various studies have
been made on the
possible interaction
between the BZD and
the AH H1 with
special attention to
their effect on the
CNS. In some cases
these were studies
to assess the safety
of this association
and in others, the
aim was different:
to see if their
joint administration
gives a better
therapeutic result
in pathology related
with anxiety
syndrome or
insomnia. In general
it can be said that
first generation AH
interact with the
BZD increasing the
sedative effects of
the latter. However,
second generation AH
do not increase
these sedative
effects, which makes
them the chosen
drugs to treat
allergic
rhinitis/rhino-conjunctivitis
and urticaria in
patients also
receiving BZD.
Key words:
Antihistamines H1
1st generation.
Antihistamines H1
2nd generation.
Benzodiazepines.
GABAergic system.
Histaminergic
system.
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