antihistamines - yay or nay

Hydroxyzine etc
akia

antihistamines - yay or nay

Post by akia »

So after reading the board every day I'm a bit confused. Should I or should I not be taking antihistamines? My chronic prostatitis / chronic pelvic pain syndrome flare up started just days after taking Chlor-Tripolon antihistamine for allergies to a cat. There is a warning on the box not to take it if you have urinary problems or prostate problems.

So why are there post saying I should take antihistamines and some saying that I shouldn't? What is the correct answer?

I'm saying nay. If my symptoms started after taking one, I'm sure as hell not going to start now.
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Post by Richard.N »

I'm no expert, but if you are particularly sensitive to the anti-cholinergic effect of anti-histamines they may not be right for you even with support from an Alpha Blocker. Or maybe you are particularly sensitive to Chlor-Tripolon? The particular brand that has been highlighted here is Atarax (Hydroxyzine).

Maybe the question should be, is Hyroxyzine fundamentally different to Chlor-Tripolon and if so, should one risk it with a history of Chlor-Tripolon intolerance?

I'm not surprised you say "nay" if your chronic prostatitis / chronic pelvic pain syndrome was brought on by an antihistamine!
Richard

Age: 39. | Onset Age: 30. Onset Date: January 2002. Symptoms (back then): Supra-pubic pain, back pain, urinary frequency, urgency and difficulty, weak stream, nocturia, (and variously) chronic fatigue, IBS. Current symptoms: more frequent than normal, but pretty much under control. Current amelioration: Xatral 10mg, Mirtazapine 30mg. | Worsened By: Stress, binge drinking, strained bowel movements, bloating, sitting on hard surfaces, jogging, and regularly - THE WINTER!

I'm not a medical expert. My comment is opinion. See your medical professional.
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Post by webslave »

The newer antihistamines do not have the same anticholinergic (antimuscarinic) effect on prostatic and bladder smooth muscle.
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Post by gunde »

I read somewhere that Cetirizine HCl (Zyrtec) is similar to or the next generation of Hydroxyzine (Atarax). Is that true?
I took Zyrtec a couple of years ago for my allergies. I don't remember if it worked well or not.
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Post by webslave »

Zyrtec is a metabolite of hydroxyzine. I am reading the IC board currently. I love those women, they gab about everything :blah1: The section on antihistamines is interesting, with some women reporting quite bad reactions to hydroxy (depression, bladder pain, retention, middle ear problems, nasal congestion ...etc) while others say its main advantage is that it helps them sleep. Many report Elavil as a better option for pain. I'm strongly considering changing to a claritin+zantac combo for my allergies, then 5mg Elavil at night to protect mast cells, and (for the easy urine flow) maybe off Flomax and back to Hytrin as well if the stomach probs are hyroxy.'s fault.

Wow! Once you start playing around with these meds, you need to keep alert and watchful for your reactions! It's a puzzle in itself.

:pensativo:
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Post by Richard.N »

Zyrtec is a metabolite of hydroxyzine
What's a metabolite?
Once you start playing around with these meds, you need to keep alert and watchful for your reactions!
You can say that again. Incidentally you may need a stool softner for Elavil - even at 5mg. I did :!:
Richard

Age: 39. | Onset Age: 30. Onset Date: January 2002. Symptoms (back then): Supra-pubic pain, back pain, urinary frequency, urgency and difficulty, weak stream, nocturia, (and variously) chronic fatigue, IBS. Current symptoms: more frequent than normal, but pretty much under control. Current amelioration: Xatral 10mg, Mirtazapine 30mg. | Worsened By: Stress, binge drinking, strained bowel movements, bloating, sitting on hard surfaces, jogging, and regularly - THE WINTER!

I'm not a medical expert. My comment is opinion. See your medical professional.
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Post by webslave »

Richard.N wrote:What's a metabolite?
It's hydroxyzine with a few nasty edges knocked off, basically.
You may need a stool softner for Elavil - even at 5mg.
Elavil also causes weight gain, I have heard, although the similar drug nortriptyline apparently does not.
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Post by Richard.N »

Elavil also causes weight gain
That may have something to do with it's relief of depression at higher doses though surely?
Richard

Age: 39. | Onset Age: 30. Onset Date: January 2002. Symptoms (back then): Supra-pubic pain, back pain, urinary frequency, urgency and difficulty, weak stream, nocturia, (and variously) chronic fatigue, IBS. Current symptoms: more frequent than normal, but pretty much under control. Current amelioration: Xatral 10mg, Mirtazapine 30mg. | Worsened By: Stress, binge drinking, strained bowel movements, bloating, sitting on hard surfaces, jogging, and regularly - THE WINTER!

I'm not a medical expert. My comment is opinion. See your medical professional.
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Post by webslave »

No. Many drugs cause an increase in appetite. Elavil is one of them, in susceptible people only, of course.
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Post by Richard.N »

in susceptible people only, of course.
I could do with putting some weight on actually. Trust me to get the 'wrong' side effects :-D
Richard

Age: 39. | Onset Age: 30. Onset Date: January 2002. Symptoms (back then): Supra-pubic pain, back pain, urinary frequency, urgency and difficulty, weak stream, nocturia, (and variously) chronic fatigue, IBS. Current symptoms: more frequent than normal, but pretty much under control. Current amelioration: Xatral 10mg, Mirtazapine 30mg. | Worsened By: Stress, binge drinking, strained bowel movements, bloating, sitting on hard surfaces, jogging, and regularly - THE WINTER!

I'm not a medical expert. My comment is opinion. See your medical professional.
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Post by Ralph »

Just about all antidepression medication can cause an increase in appetite. This is a big problem for some taking the newer drugs such a Prozac and Paxil. Elavil is a much older drug and also in a different class (tricyclic), but can still have this side effect. However, I think Richard mentioned it, at these low doses (5mg) wieght gain is unlikely.
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Post by Richard.N »

I've been on 25mg of Elavil for a few weeks now. I would consider going up a notch to promote weight gain to be honest - but I don't think I could tolerate the retention at a higher dose :-D
Richard

Age: 39. | Onset Age: 30. Onset Date: January 2002. Symptoms (back then): Supra-pubic pain, back pain, urinary frequency, urgency and difficulty, weak stream, nocturia, (and variously) chronic fatigue, IBS. Current symptoms: more frequent than normal, but pretty much under control. Current amelioration: Xatral 10mg, Mirtazapine 30mg. | Worsened By: Stress, binge drinking, strained bowel movements, bloating, sitting on hard surfaces, jogging, and regularly - THE WINTER!

I'm not a medical expert. My comment is opinion. See your medical professional.
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Post by webslave »

Fernstrom and Kupfer (Psychiatry Research, 26: 256-271, 1988) compared weight change in patients treated with amitriptyline, nortriptyline, desipramine, and zimelidine. They reported weight gain in 89% of patients treated with amitriptyline, 67% of patients treated with nortriptyline, 58% of patients treated with desipramine, and 8% of those treated with zimelidine. They found a positive correlation between amitriptylilne dose and weight gain.
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Post by Richard.N »

Mark - in your reading, have you found that any of the Tricyclics are LESS likely to cause retention?
Richard

Age: 39. | Onset Age: 30. Onset Date: January 2002. Symptoms (back then): Supra-pubic pain, back pain, urinary frequency, urgency and difficulty, weak stream, nocturia, (and variously) chronic fatigue, IBS. Current symptoms: more frequent than normal, but pretty much under control. Current amelioration: Xatral 10mg, Mirtazapine 30mg. | Worsened By: Stress, binge drinking, strained bowel movements, bloating, sitting on hard surfaces, jogging, and regularly - THE WINTER!

I'm not a medical expert. My comment is opinion. See your medical professional.
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Post by Ralph »

I'm sure Mark will be able to answer you. His knowlegde resource is amazing. I don't know about the weight gain issue with the tricyclics, but Elavil is the best for chroinc pain conditions. You will probably loose the benefit of the medication if you switch just to gain weight. Elavil is commonly used for Herpes Zoster (Shingeles). It works well in many poeple.
Ralph Caccese, MD (Radiologist)