DaveFoster
Member
Dr. Peat has wrote about the tendency of histamine (largely promoted by estrogen in the context of an inflammatory response) to promote nerve excitation and cause anxiety. Antihistamines can treat anxiety disorders, and they lack the negative effects of benzodiazepine drugs, such as mitochondrial fragmentation and predisposition to neurodegenerative diseases (including severe amnesia), as well as physical addiction and withdrawal symptoms including seizures.
Many drugs with antihistamine effects, including the tricyclic antidepressants (TCA's) prolong the QT-interval (a process detrimental the heart's ability to contract,) particularly amitriptyline and imipramine, but also the newer generation tetracyclic antidepressant mirtazapine, serotonin-norepinephrine reuptake inhibitors (SNRI's), selective-serotonin reuptake inhibitors (SSRI's) and so on.
Hydroxyzine mildly prolongs the QT-interval, but the drug doesn't possess the long-term neurodegenerative potential of the benzodiazepine drugs. The antihistamine cyproheptadine does not prolong the QT-interval, but it can cause severe weight gain if taken in therapeutic dosages to treat anxiety. Hydroxyzine has a lower propensity for weight gain, but chemically behaves similarly to cyproheptadine.
Hypothyroidism and estrogen lengthen the QT-interval, whereas progesterone shortens it. Euthyroidism and substances including progesterone, vitamin E, niacinamide, pregnenolone, l-theanine, and aspirin dissolved in hot water with glycine and baking soda to prevent stomach irritation, along with the consumption of a diet that minimizes gut inflammation can lower anxiety.
For anxiety disorders including social anxiety disorder (SAD) and generalized anxiety disorder (GAD), some psychiatrists provide anxiolytics (anti-anxiety drugs) such as antihistamines with expectations of ECG testing to recognize cardiac (heart) abnormalities. Antihistamines can initially cause drowsiness, which can be minimized by consuming a small fraction of the therapeutic dose and titrating the dosage upwards over several weeks. Maintaining a relatively steady serum-concentration of the antihistamine through frequent dosing and careful monitoring for side effects, or taking the drug before bed can reduce variance in individual responses.
Hydroxyzine metabolizes in cetirizine, and Dr. Peat has mentioned the tendency for chlorinated carbon molecules to cause hepatic (liver) problems. Cyproheptadine by itself can inflame the liver, but neither cyproheptadine nor diphenhydramine contain chlorinated carbon molecules and therefore present a diminished risk for liver damage by this mechanism. Similarly to hydroxyzine, diphenhydramine mildly prolongs the QT-interval for cardiac repolarization.
"This multicenter, parallel (hydroxyzine [50 mg/day]; bromazepam [6 mg/day])...12 weeks of double-blind randomized treatment..Results at endpoint for percentage of responders (p =.003) and remission rates (p =.028), Clinical Global Impressions-Severity scale score (p =.001), maintenance of efficacy (p =.022), and Hospital Anxiety and Depression scale score on day 84 (p =.008) also confirmed the efficacy of hydroxyzine over placebo. The study showed no statistically significant difference between hydroxyzine and bromazepam.[a benzodiazepine drug] Except for drowsiness, which was more frequent with bromazepam, safety results were comparable in the 3 groups.
Hydroxyzine showed both efficacy and safety in the treatment of GAD and appears to be an effective alternative treatment to benzodiazepine prescription."
Reference: Efficacy and safety of hydroxyzine in the treatment of generalized anxiety disorder: a 3-month double-blind study. - PubMed - NCBI
Originally posted on the Foster Your Health blog: The Antihistamine Hydroxyzine Treats Anxiety
Many drugs with antihistamine effects, including the tricyclic antidepressants (TCA's) prolong the QT-interval (a process detrimental the heart's ability to contract,) particularly amitriptyline and imipramine, but also the newer generation tetracyclic antidepressant mirtazapine, serotonin-norepinephrine reuptake inhibitors (SNRI's), selective-serotonin reuptake inhibitors (SSRI's) and so on.
Hydroxyzine mildly prolongs the QT-interval, but the drug doesn't possess the long-term neurodegenerative potential of the benzodiazepine drugs. The antihistamine cyproheptadine does not prolong the QT-interval, but it can cause severe weight gain if taken in therapeutic dosages to treat anxiety. Hydroxyzine has a lower propensity for weight gain, but chemically behaves similarly to cyproheptadine.
Hypothyroidism and estrogen lengthen the QT-interval, whereas progesterone shortens it. Euthyroidism and substances including progesterone, vitamin E, niacinamide, pregnenolone, l-theanine, and aspirin dissolved in hot water with glycine and baking soda to prevent stomach irritation, along with the consumption of a diet that minimizes gut inflammation can lower anxiety.
For anxiety disorders including social anxiety disorder (SAD) and generalized anxiety disorder (GAD), some psychiatrists provide anxiolytics (anti-anxiety drugs) such as antihistamines with expectations of ECG testing to recognize cardiac (heart) abnormalities. Antihistamines can initially cause drowsiness, which can be minimized by consuming a small fraction of the therapeutic dose and titrating the dosage upwards over several weeks. Maintaining a relatively steady serum-concentration of the antihistamine through frequent dosing and careful monitoring for side effects, or taking the drug before bed can reduce variance in individual responses.
Hydroxyzine metabolizes in cetirizine, and Dr. Peat has mentioned the tendency for chlorinated carbon molecules to cause hepatic (liver) problems. Cyproheptadine by itself can inflame the liver, but neither cyproheptadine nor diphenhydramine contain chlorinated carbon molecules and therefore present a diminished risk for liver damage by this mechanism. Similarly to hydroxyzine, diphenhydramine mildly prolongs the QT-interval for cardiac repolarization.
"This multicenter, parallel (hydroxyzine [50 mg/day]; bromazepam [6 mg/day])...12 weeks of double-blind randomized treatment..Results at endpoint for percentage of responders (p =.003) and remission rates (p =.028), Clinical Global Impressions-Severity scale score (p =.001), maintenance of efficacy (p =.022), and Hospital Anxiety and Depression scale score on day 84 (p =.008) also confirmed the efficacy of hydroxyzine over placebo. The study showed no statistically significant difference between hydroxyzine and bromazepam.[a benzodiazepine drug] Except for drowsiness, which was more frequent with bromazepam, safety results were comparable in the 3 groups.
Hydroxyzine showed both efficacy and safety in the treatment of GAD and appears to be an effective alternative treatment to benzodiazepine prescription."
Reference: Efficacy and safety of hydroxyzine in the treatment of generalized anxiety disorder: a 3-month double-blind study. - PubMed - NCBI
Originally posted on the Foster Your Health blog: The Antihistamine Hydroxyzine Treats Anxiety
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