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Re: Promethazine gives me the most peaceful sleep but » jerryTRD

Posted by ed_uk2010 on November 6, 2010, at 14:24:01

In reply to Re: Promethazine gives me the most peaceful sleep but » ed_uk2010, posted by jerryTRD on November 6, 2010, at 13:54:33

Hi Jerry,

>Ed - do you know of any long-term use side effects?

Adverse effects such as dizziness and drowsiness are very common. Serious side effects are rare, but may include jaundice, blood disorders and hypersensitivity to sunlight. Avoid strong sunlight.

>I don't understand why my docs are shying away from using this since it's been working much better than the Seroquel.

It's old and out of fashion. They haven't seen any glossy adverts for it. American docs love shiny new meds.

>And does it have LESS of a risk of EPS/Tardive Dyskinesia effects than mends like Seroquel?

I expect that the risk of TD is similiar to Seroquel, maybe lower. There aren't many reports. Promethazine is not sufficiently potent as a dopamine antagonist to be used alone as an antipsychotic, although it can be added to antipsychotics if increased sedation is required. An traditional treatment for severe acute agitation in mania or schizophrenia was haloperidol + promethazine. This is still sometimes used as a cheaper alternative to the likes of Zyprexa, especially in developing countries where Zyprexa is out of the question.

Promethazine is prescribed quite freuquently in the UK. It's used in children for insomnia (especially due to severe itching when eczema/dermatitis has been difficult to control), it's used for travel sickness when sedation is appropriate, for insomnia in adults when daytime drowsiness is acceptable, and for insomnia when potentially abusable meds are not appropriate. It's available OTC but many pharmacists are cautious about selling the large pack sizes because they feel that medical supervision is advisable for regular use.

As is the case with all sedative antihistamines, tolerance to the sleep inducing effects can develop fairly quickly in some cases.

 

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