Institute of Pharmaceutical Sciences, King's College London, London, UK.
Department of Pharmacy, School of Applied Sciences, University of Huddersfield, Huddersfield, UK.
Br J Clin Pharmacol. 2021 Oct;87(10):3978-3987. doi: 10.1111/bcp.14819. Epub 2021 Mar 31.
Antihistamines are routinely taken to control allergic reactions or sedation to induce sleep. There are, however, growing concerns regarding sedating antihistamine misuse. This research aims to evaluate deaths related to antihistamines in England occurring during 2000-2019.
Cases reported to the National Programme on Substance Abuse Deaths from England occurring in 2000-2019 with antihistamine detections at postmortem were extracted for analysis.
In total, 1666 antihistamine postmortem detections were identified from 1537 cases. Sedating antihistamines available for purchase under pharmacist supervision but without need for a prescription (pharmacy-only medications) were present in a significant majority of cases (85.2%, P < .01). Despite an increasing trend for antihistamine-related deaths over time, the proportion of deaths where an antihistamine was implicated declined over the same period. Specific concerns with regards to the misuse of these pharmacy-only sedating antihistamines are raised with regards to the significant proportion of cases that were concluded as suicide (20.9%, P < .01), and the high prevalence of their use in combination with other central nervous system depressants (94.8% of cases).
This is the first report in over 40 years regarding antihistamine-related mortality from England. The rising trend in sedating antihistamine-related deaths may be contributed to by their increasing availability and the perceived negligible dangers associated with antihistamines, both from the general public and learned professionals. Awareness of the dangerous sedative properties that some antihistamines possess is, however, heightened in individuals deliberately seeking these effects. Urgent review of sedating antihistamines currently assigned under the pharmacy-only classification is needed to achieve antihistamine harm reduction.
抗组胺药通常被用于控制过敏反应或镇静以诱导睡眠。然而，人们越来越关注镇静性抗组胺药的滥用问题。本研究旨在评估 2000 年至 2019 年期间英格兰与抗组胺药相关的死亡事件。
从英格兰国家药物滥用死亡计划中提取了 2000 年至 2019 年期间报告的与抗组胺药相关的案例，并对其进行了分析。
共从 1537 例病例中发现了 1666 例抗组胺药死后检测结果。在大多数病例中（85.2%，P<0.01），可在药剂师监督下购买但无需处方的镇静性抗组胺药（仅限药剂师配药的药物）都有发现。尽管抗组胺药相关死亡人数呈上升趋势，但同期被牵连的死亡人数比例却有所下降。对于这些仅限药剂师配药的镇静性抗组胺药的滥用问题，人们特别关注到自杀案例的比例很高（20.9%，P<0.01），以及它们与其他中枢神经系统抑制剂联合使用的高流行率（94.8%的病例）。
这是 40 多年来首次关于英格兰与抗组胺药相关的死亡率报告。镇静性抗组胺药相关死亡人数的上升趋势可能归因于其可用性的增加以及公众和专业人士普遍认为抗组胺药的危害可以忽略不计。然而，一些人故意寻求这些效果，这提高了他们对抗组胺药具有危险镇静作用的认识。需要紧急审查目前按仅限药剂师配药分类的镇静性抗组胺药，以实现抗组胺药的危害减少。
