Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0015672 (fatigue)
 51,768 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The efficacy of terfenadine, a nonsedating H1 antihistamine, in the management of chronic idiopathic urticaria was compared with chlorpheniramine and placebo in a parallel multicenter trial. Subjects with symptoms of hives for 3 days per week for at least 6 weeks were initially screened and admitted if no identifiable cause for symptoms could be determined. Patients entered a single-blind placebo period, and if hives of moderate severity were present for at least 3 days during the week, they were randomly assigned in a double-blind fashion to take terfenadine, 60 mg twice daily, chlorpheniramine, 4 mg three times a day, or placebo for 6 weeks. Data were analyzed for 122 patients. Those patients receiving both active treatments noted significant improvement in symptoms: pruritus, redness, number of hives, and waking hours during which hives were present, at the end of the first day of therapy. Symptom control by terfenadine was statistically superior to placebo during all 6 weeks, as rated by both patients and investigators. However, statistical significance was not achieved for chlorpheniramine at all observation points. Diphenhydramine was permitted as a relief medication for refractory symptoms and was taken by 52% of subjects receiving placebo, 26% taking chlorpheniramine, and only 9% of patients who were receiving terfenadine. In addition to providing superior symptom control, terfenadine caused less drowsiness and fatigue than chlorpheniramine. Terfenadine is a useful therapeutic agent for primary management of chronic idiopathic urticaria.
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PMID:Double-blind comparison of terfenadine, chlorpheniramine, and placebo in the treatment of chronic idiopathic urticaria. 312 20

The majority of antihistamines have sedative effects; however, it is claimed that Hismanal (astemizole) does not possess central nervous system side effects. A three-factor, repeated measures, double-blind design was used to compare the effects of singl oral doses of 1) Benadryl (diphenhydramine), 50 mg; 2) Hismanal, 10 mg; and 3) placebo, on two mood scales, physiological measures, sleepiness, the ability to detect ingestion of an antihistamine versus placebo, and symptoms in 28 healthy men. Higher tension, greater fatigue, and lower activity levels were reported post-Benadryl (p < 0.05). Lower vigor-activity and higher confusion-bewilderment post-Hismanal and Benadryl were noted 1 h postingestion (p < 0.05), with confusion being lower and activity higher for Hismanal than for Benadryl (p < 0.05). Low vigor-activity, high confusion, and increased sleepiness post-Benadryl persisted for 3 h, while fatigue-inertia persisted for 7 h (p < 0.05). Results suggest that Hismanal is superior to Benadryl for avoidance of subjective effects; however, neither antihistamine was entirely devoid of subjective effects.
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PMID:The effects of Benadryl and Hismanal on mood, physiological measures, antihistamine detection, and subjective symptoms. 836 85

The most disabling form of Parkinsonism is that occurring after encephalitis. It may occur in persons of any age. The results of surgical treatment, which has been used for the most part only for seriously handicapped patients, have been discouraging in general, although in a few isolated circumstances operation has been of dramatic benefit.The solanaceous alkaloids-atropine, stramonium and hyoscine-either in pure forms or in mixed extracts or tinctures - are the best established drugs at present for the treatment of the postencephalitic forms of Parkinsonism. They have not proven too helpful for patients in the older age group with paralysis agitans. The antihistaminic compounds, particularly Benadryl,(R) have been a very valuable addition. They are of greatest value for patients in the older age group. The newer synthetic compounds, Artane(R) and Panparnit,(R) are also valuable additions. Amphetamine and the related and subsequently produced agents in this group are very helpful for patients showing undue fatigue and lethargy. Tolserol(R) is proving helpful, particularly for patients with painful spasms of rigid muscles.
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PMID:Therapy of Parkinson's disease. 1477 55

Arousal is regulated by the interplay between wakefulness- and sleep-promoting nuclei. Major wakefulness-promoting nuclei are the histaminergic tuberomamillary nucleus (TMN) of the hypothalamus and the noradrenergic locus coeruleus (LC) of the pons, which also play a role in autonomic regulation. First generation antihistamines, such as diphenhydramine, are likely to cause sedation by blocking excitatory H1 histamine receptors in the cerebral cortex, and the anti-narcolepsy drug modafinil may promote wakefulness by activating the locus coeruleus. We compared the effects of single doses of diphenhydramine (75 mg) and modafinil (200 mg) on arousal and autonomic functions in 16 healthy male volunteers, using a placebo-controlled, balanced, double-blind design. Arousal was assessed by critical flicker fusion frequency (CFFF), visual analogue scales (VAS) and pupillary fatigue waves (Pupillographic Sleepiness Test (PST)). Autonomic functions measured included resting pupil diameter, light and darkness reflex responses, blood pressure, heart rate and salivation. Data were analysed with ANOVA, with multiple comparisons. Diphenhydramine had sedative effects as shown by reductions in CFFF, VAS alertness ratings and increases of the indices of pupillary fatigue. Modafinil had alerting effects as indicated by reductions in the measures of pupillary fatigue. Comparison of pre-post medication changes in pupil diameter showed a decrease after diphenhydramine and an increase after modafinil. Diphenhydramine reduced salivation, and modafinil increased systolic blood pressure. In conclusion, diphenhydramine and modafinil evoked opposite effects on arousal and sympathetic functions, which are likely to reflect their interaction with the central histaminergic and noradrenergic systems. Hyposalivation by diphenhydramine is likely to be due to its additional anticholinergic property.
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PMID:Comparison of diphenhydramine and modafinil on arousal and autonomic functions in healthy volunteers. 1709 78