Intake of the First-Generation Anti-Histamines in Early Childhood May Have an Adverse Effect on Cognitive Function. Population Based Pharmacoepidemiologic Study in Non-Asthamtic Children

Wieslaw A Jedrychowski

doi:10.4172/2167-1052.1000138

Abstract

As the allergic diseases increase steadily worldwide, the main goal of the study was to assess the association between the early intake of the first-generation sedative antihistamines in young non-asthmatic children and their cognitive function at the age of 7. The size of the exposure effect was measured by the Wechsler intelligence Scale for Children (WISC-R) and adjusted in multivariable models for major confounders known to be important for children cognitive development. The study included 212 children who were non-asthmatic and completed the monitoring of antihistamines intake over 3 years preceding the WISC-R intelligence testing. While the first-generation drugs were used by 36.7% children and the newer generation by 39.6%, both categories of drugs were taken by 17.8% children. The analysis showed the deficit of 12 points on the verbal WISC-R IQ scale only in children who used the first- generation antihistamines for a longer time (beta coeff.=-11.7, 95% CI: -19.6, -3.7) compared to non-users. Out of the covariates included in the multivariable regression models, maternal education (beta coeff.=0.92, 95% CI: 0.37, 1.46) and breastfeeding at least for 6 months (beta coeff.=3.29; 95% CI: 0.34, 6.23) showed a significant positive impact on the verbal IQ. Intake of the newer generation antihistamines were associated neither with verbal nor performance IQ scores. Concluding, the results suggest that the “sedative antihistamines” have a negative impact on the verbal but not performance IQs of young children if drugs were used over a longer period. The weaker verbal communication ability of young children may hinder the cognitive development of children and be associated with relatively poor school academic achievements

Highlights

Drugs with antihistamine action are among the commonly prescribed medicines in pediatrics for the symptomatic treatment of various allergic disorders such as, seasonal and perennial allergic rhinitis, conjunctivitis, atopic dermatitis or chronic urticaria
Concluding, the results suggest that the “sedative antihistamines” have a negative impact on the verbal but not performance IQs of young children if drugs were used over a longer period
As the characteristics of the subjects included in the analysis did not reveal significant differences compared with the group of children who dropped out of the study, except for the children’s gender, we may assume that the material included in the analysis was representative of the population sample recruited initially (Table 2)

Summary

Introduction

Drugs with antihistamine action are among the commonly prescribed medicines in pediatrics for the symptomatic treatment of various allergic disorders such as, seasonal and perennial allergic rhinitis, conjunctivitis, atopic dermatitis or chronic urticaria. Antihistamines presently available on the market have been classified as first, second or third generation drugs and they differ in the chemical structures, pharmacodynamics, pharmacokinetics and adverse health events [1,2,3,4,5]. First-generation antihistamines used traditionally (diphenhydramine, chlorpheniiramine, clemastine, hydroxyzine, triprolidine and promethazine) are highly lipid soluble, have a low molecular weight and a high affinity for cerebral H1 receptors. They cross the blood brain barrier and show highly sedating effect on central nervous system even at low therapeutic doses. As children are more sensitive to the side-effects of drugs than adults, the side effects may have implications for their further long-term intellectual development

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