Department of Dermatology and Venereology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.
Dermatol Ther. 2019 Jul;32(4):e12993. doi: 10.1111/dth.12993. Epub 2019 Jul 14.
Doxepin is an old tricyclic antidepressant, whose efficacy in chronic urticaria had been well documented until 1990. However, over the past three decades, there has been limited data on its use. We aimed to assess the efficacy and safety of doxepin in the treatment of patients with chronic urticaria who were poorly responsive to antihistamines. In this retrospective, cross-sectional, single-center study from Turkey, data were examined from patients with chronic urticaria who had poor antihistamine responses and received doxepin therapy from 1998 to 2017. Patient data were analyzed with regard to the duration of the disease, age, sex, treatment outcomes using a weekly urticaria activity score (UAS7), and adverse effects of doxepin therapy. A reduction of ≥90% in UAS7 was defined as "complete response," 30-89% as "partial response" and <30% as "no significant response." Thirty-six patients were included in this study. Doxepin was effective in a majority (n = 27, 75%) of the patients with a short onset time. Sixteen patients (44.4%) showed a complete response. Mild sedative and anticholinergic side effects were well tolerated. Doxepin seems to be a reasonable, efficient, and affordable alternative for the treatment of chronic urticaria in patients who respond poorly to antihistamine therapy.
多塞平是一种三环类抗抑郁药，其在慢性荨麻疹中的疗效在 1990 年之前已有充分的文献记载。然而，在过去的三十年中，关于其应用的数据有限。我们旨在评估多塞平治疗对抗组胺药反应不佳的慢性荨麻疹患者的疗效和安全性。在这项来自土耳其的回顾性、横断面、单中心研究中，对 1998 年至 2017 年期间接受多塞平治疗的对抗组胺药反应不佳的慢性荨麻疹患者的数据进行了检查。对患者的疾病持续时间、年龄、性别、使用每周荨麻疹活动评分（UAS7）的治疗结果以及多塞平治疗的不良反应进行了分析。UAS7 降低≥90%定义为“完全缓解”，30-89%为“部分缓解”，<30%为“无显著缓解”。本研究共纳入 36 例患者。多塞平对大多数（n=27，75%）患者起效迅速，且疗效显著。16 例患者（44.4%）出现完全缓解。轻度镇静和抗胆碱能副作用可耐受。对于对抗组胺药治疗反应不佳的慢性荨麻疹患者，多塞平似乎是一种合理、有效且经济实惠的替代治疗选择。
