Love to hear about the IOCDF conference

[Ebersolk]

Is there any antihistimines that are better to use than others?

[Iowadawn]

Hello Kerry,

 

The first generation are H1 antihistamines and cross the BBB. Vistaril (hydroxazine) is unique among the first gens H1's in it's anti-anxiety abilities. We haven't found it to be sedating. It is still used as a calmer-downer drug pre-surgery or dental procedures. The nice thing about it is the ability to layer additional anxiety/sedating drugs on top should more be needed because there is little (if any) interaction. I only speak from our experience with this drug and do NOT say it is best.

 

The earlier posts with all the links gave me a better understanding, also.

 

I am curious on Swedo's take on the H2 antihistamines.

 

My two cents. -Dawn

[MomWithOCDSon]

Is there any antihistimines that are better to use than others?

 

We like two in particular: quercitin, which is an over-the-counter amino acid that helps prevent mast cells from producing histamine, so it works way upstream of most of the other antihistamines and has no sedatory properties that we know of, and Pepcid, which is an H2 blocker. The Pepcid works well for us because it is predominantly active in the gut, so no sedatory properties at all.

Edited August 2, 2012 by MomWithOCDSon

[MomWithOCDSon]

I am curious on Swedo's take on the H2 antihistamines.

 

My two cents. -Dawn

 

Wish I'd had a chance to talk to her more about it myself, but I didn't want to monopolize her time or the question & answer session (which I very easily could have! ). Thinking about dropping her an email on the topic to follow up. If I do, I'll be sure to report back.

 

Interested in vistaril, though, now that it's been mentioned by a couple of people. Earlier, our psych had mentioned a choice of a couple of anti-seizure meds used off-lable for anxiety: one of 'em had antihistamine properties, and the other had glutamate modulating properties. We opted for the second, but wonder now if the first might not've had some benefits of which we weren't aware at the time.

[kos_mom]

Nancy,

Zantac, which my daughter takes,is also an H-2 blocker. Is Pepcid in some way superior and should I switch her to it? Interesting about Atarax. DD once had it prescribed when her allergies were very bad--she used to make a point of reminding me to make sure I put her little red pill out. Maybe she was feeling something from it she wasn't communicating to me--perhaps I can cadge another prescription from her allergist.

Thanks,

Ko's Mom

[MomWithOCDSon]

Nancy,

Zantac, which my daughter takes,is also an H-2 blocker. Is Pepcid in some way superior and should I switch her to it? Interesting about Atarax. DD once had it prescribed when her allergies were very bad--she used to make a point of reminding me to make sure I put her little red pill out. Maybe she was feeling something from it she wasn't communicating to me--perhaps I can cadge another prescription from her allergist.

Thanks,

Ko's Mom

 

I've not heard or read of anything that would suggest that Pepcid is better or worse than Zantac; from what I can tell, they pretty much do the same thing, with the same side effect profile (which is low). Pepcid just happened to be the H2 blocker suggested to us by a nurse, and since it's widely available in generic (and dye-free) forms, we tried it.

 

I think the main thing is not to confuse H2 blockers with proton pump inhibitors (PPIs) like Nexium, Prilosec or Prevacid. Those work similarly in terms of reducing reflux and other stomach acid issues, but they don't work on the histamine system, so far as I know.

[kos_mom]

Thanks Nancy. How often are dosing the Pepcid--once a day or more often? Thanks.

[dut]

Hi - I read some time ago that H2 antihistamines good and H1 bad for the BBB.

 

It was a great study that I read but haven't since been able to find and wondered if i'd imagined it. Based on this previous reading, I avoid H1 antihistamines in my PANDAS kids because the study said that they can increase permeability whilst H2 will downregulate the right type of histamine and lower permeability.

 

This thread sent me searching for the original study which I still can't find but did find these that may be of interest....

 

 

http://www.ncbi.nlm.nih.gov/pubmed/10696506

 

"Histamine is one of the few central nervous system neurotransmitters found to cause consistent blood-brain barrier opening. The earlier literature was unclear, but studies of pial vessels and cultured endothelium reveal increased permeability mediated by H2 receptors and elevation of [Ca2+]i and an H1 receptor-mediated reduction in permeability coupled to an elevation of cAMP."

 

 

http://www.sciencedirect.com/science/article/pii/0306452292904366

 

 

http://www.pnas.org/content/early/2010/10/12/1008816107.full.pdf

Edited August 2, 2012 by dut

[MomWithOCDSon]

Thanks Nancy. How often are dosing the Pepcid--once a day or more often? Thanks.

 

We give Pepcid once daily . . . about 10 minutes before dinner . . . but my DS was also suffering from reflux, so there was a viable reason for dosing it before a meal. I know some families give at bedtime, just for its antihistamine properties, but so it doesn't interfere with digestion at all.

 

Also will note that, when things are calm and DS is in a good place, we stick with the "regular strength," 10 mg. But when he's ramped up and his eczema flairs, we switch for a bit to the 20 mg. "maximum strength" Pepcid and that seems to be beneficial.

 

Good luck!

[kos_mom]

Nancy, Much thanks--DD has mysterious gastric complaints and won't face the day without taking Zantac first thing. She still has gastric issues, so maybe a night time dose would be helpful.

[EAMom]

Thanks Nancy. How often are dosing the Pepcid--once a day or more often? Thanks.

 

We give Pepcid once daily . . . about 10 minutes before dinner . . . but my DS was also suffering from reflux, so there was a viable reason for dosing it before a meal. I know some families give at bedtime, just for its antihistamine properties, but so it doesn't interfere with digestion at all.

 

Also will note that, when things are calm and DS is in a good place, we stick with the "regular strength," 10 mg. But when he's ramped up and his eczema flairs, we switch for a bit to the 20 mg. "maximum strength" Pepcid and that seems to be beneficial.

 

Good luck!

 

Does anyone know of it is better to take probiotics with an h2 blocker? Or take the probiotics at a different time? Or does it matter?

Edited August 3, 2012 by EAMom

[MomWithOCDSon]

Does anyone know of it is better to take probiotics with an h2 blocker? Or take the probiotics at a different time? Or does it matter?

 

Maybe someone else will chime in here. I honestly don't know if it's better, worse or doesn't matter. But we do give probiotics, too, though not at the same time as the Pepcid. DS gets probiotic in the morning, and one at bedtime, with the Pepcid at dinner. From what we can tell, both interventions retain their efficacy on that schedule.

[JAG10]

Nancy,

So grateful to you for sharing your notes and knowledge!

My girls have been doing well behaviorally. DD12 is now 14 weeks past her last IVIG. This histamine conversation caught my eye. Both girls and myself- we are covered in bug bites again. I don't think it's just Mosquitos either; some result in wide, flat reactions while others are more focal and intense. We are not out at dusk yet we are covered. My older girl who had the OCD with scratching then picking has been very responsible and diligent about taking care of each bite early so they don't get to a point where they scab. Sorry, kinda gross info.

Alright, so bug bites are a histaminic response and all 3 of us respond to a much greater degree than normal. Does anybody know where this whole H1/H2 receptor conversation fits in with focal, cutaneous reactions? As far as I can tell, we do not suffer from systemic allergies; maybe a little when the pollen count is really high, like over 10 but that is really nothing compared to so many sufferers. I just really think the way we respond to insect bites is weird. And dousing them in deet everyday for months is not an option. Any ideas if this fits in anywhere??? Anyone?

Can't wait to read more info on the conference as well. Any news about Dr. Cunningham's lab?

Jill

[MomWithOCDSon]

Nancy,

So grateful to you for sharing your notes and knowledge!

My girls have been doing well behaviorally. DD12 is now 14 weeks past her last IVIG. This histamine conversation caught my eye. Both girls and myself- we are covered in bug bites again. I don't think it's just Mosquitos either; some result in wide, flat reactions while others are more focal and intense. We are not out at dusk yet we are covered. My older girl who had the OCD with scratching then picking has been very responsible and diligent about taking care of each bite early so they don't get to a point where they scab. Sorry, kinda gross info.

Alright, so bug bites are a histaminic response and all 3 of us respond to a much greater degree than normal. Does anybody know where this whole H1/H2 receptor conversation fits in with focal, cutaneous reactions? As far as I can tell, we do not suffer from systemic allergies; maybe a little when the pollen count is really high, like over 10 but that is really nothing compared to so many sufferers. I just really think the way we respond to insect bites is weird. And dousing them in deet everyday for months is not an option. Any ideas if this fits in anywhere??? Anyone?

Can't wait to read more info on the conference as well. Any news about Dr. Cunningham's lab?

Jill

Jill --

 

Maybe check a couple of those links I posted earlier up this topic; there's a basic one and as I recall there's a chart there that shows which histaminergic response is tied to which receptor. I think insect bites fall into the H1 category, but don't quote me on it.

 

Dr. Swedo commented that Dr. Cunningham's lab would be up and running "soon," but I didn't happen to hear anything more specific than that, sorry. Maybe someone else did?

[LaurenK]

Swedo said that there is the possibility of permanent brain damage from PANDAS?