![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 14 of 14. This is the beginning of the thread.
Posted by zeugma on January 18, 2006, at 19:06:29
1: Med Hypotheses. 2006 Jan 10; [Epub ahead of print]
Chlorpheniramine, selective serotonin-reuptake inhibitors (SSRIs) and over-the-counter (OTC) treatment.Hellbom E.
Saningsvagen 86, S-17552 Jarfalla, Sweden.
Some old antihistamines were selective serotonin-reuptake inhibitors (SSRIs) and the SSRI effect was discovered by Nobel Laureate Professor Arvid Carlsson as early as 1969. Chlorpheniramine was the most active of the tested drugs, and it compares favourably with amitriptyline and imipramine with respect to actions on both serotonergic and noradrenergic neurons. Chlorpheniramine can be called a SSRI, since the blocking of 5HT is stronger than the effect on noradrenaline neurons; however it might also be called a selective serotonin and noradrenaline reuptake inhibitor (SSNRI) and be compared with new drugs, such as venlafaxine. Carlsson suggested the potential value of clinical studies of the antidepressant properties of this and related antihistamine drugs. But, in the event, no such trials were ever performed at the time. However, later clinical observations of the benefits of dex-chlorpheniramine treatment in panic disorder have been published. Clinical experience suggests that patients using chlorpheniramine, and having also a concomitant depression or panic disorder, may experience a return of symptoms when their old drug is changed to a new antihistamine lacking SSRI effects. Yet this phenomenon is not known to many doctors, and even less known to the large number of patients buying chlorpheniramine under various trade names over-the-counter (OTC) at a low price for self-treatment of hay fewer or as a cold remedy. Chlorpheniramine was introduced in USA under the name Chlor-Trimeton as long ago as July 1950, and is still on the market. Therefore, this SSRI is now over 50 years old. If chlorpheniramine had been tested in depression in the nineteen seventies, it is probable that a safe, inexpensive SSRI drug could have been used some 15 years earlier than fluoxetine - which became available in 1987. Chlorpheniramine might have been the first safe, non-cardiotoxic and well-tolerated antidepressant. Billions of dollars in the development and marketing costs would have been saved, and the suffering of millions of patients alleviated.>>
It amazes me how the pharmaceutical industry is continually engaged in reinventing the wheel, since a new wheel does not necessarily offer any advatages over the old one, but it does offer profit and the promise of a 'safe, effective new treatment.' I wonder if this is available in my local pharmacy.
-z
Posted by Phillipa on January 18, 2006, at 20:06:36
In reply to OTC SSNRI, posted by zeugma on January 18, 2006, at 19:06:29
Zeugma chlor-metron? I think I've heard of it before. Is it sold under any other name? Fondly, Phillipa
Posted by zeugma on January 18, 2006, at 20:29:37
In reply to Re: OTC SSNRI » zeugma, posted by Phillipa on January 18, 2006, at 20:06:36
phillipa, unfortunately i am not up to research right now.
but this bears investigation. studies have been done e.g. in panic disorder using this compound though i don't have access to the full texts and there are no abstracts (mysteriously).
but i'll look into it. it's been around a long time.
-z
Posted by flmm on January 18, 2006, at 21:27:43
In reply to Re: OTC SSNRI » Phillipa, posted by zeugma on January 18, 2006, at 20:29:37
I remember when I was young, Alka-Seltzer Cold Plus used to help my anxiety.
Posted by djmmm on January 18, 2006, at 21:39:28
In reply to Re: OTC SSNRI » zeugma, posted by Phillipa on January 18, 2006, at 20:06:36
> Zeugma chlor-metron? I think I've heard of it before. Is it sold under any other name? Fondly, Phillipa
It's just plain old Chlor-Trimeton (Schering-Plough HealthCare Products)
http://www.nlm.nih.gov/medlineplus/druginfo/medmaster/a682543.html
note the following in some of the monographs I have read: "Do not take chlorpheniramine if you have taken a monoamine oxidase inhibitor (MAOI) such as isocarboxazid (Marplan), phenelzine (Nardil), or tranylcypromine (Parnate) in the last 14 days. A very dangerous drug interaction could occur, leading to serious side effects."
Posted by Phillipa on January 18, 2006, at 22:00:18
In reply to Re: OTC SSNRI, posted by djmmm on January 18, 2006, at 21:39:28
Ahhhh pheusophed is in it. I remember before anxiety/depression it would wire me couldn't take it remember the last time I did I was working and shaking at the same time. Fondly, Phillipa
Posted by yxibow on January 19, 2006, at 0:22:16
In reply to Re: OTC SSNRI, posted by djmmm on January 18, 2006, at 21:39:28
> > Zeugma chlor-metron? I think I've heard of it before. Is it sold under any other name? Fondly, Phillipa
>
> It's just plain old Chlor-Trimeton (Schering-Plough HealthCare Products)
>
> http://www.nlm.nih.gov/medlineplus/druginfo/medmaster/a682543.html
>
> http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=14684260&query_hl=2&itool=pubmed_docsum
>
> note the following in some of the monographs I have read: "Do not take chlorpheniramine if you have taken a monoamine oxidase inhibitor (MAOI) such as isocarboxazid (Marplan), phenelzine (Nardil), or tranylcypromine (Parnate) in the last 14 days. A very dangerous drug interaction could occur, leading to serious side effects."That's because of drug-drug interactions, that's not because clorpheniramine maleate makes a great SSRI. It's not even the best antihistamine but it is average for OTC drug needs.
Posted by Glydin on January 19, 2006, at 13:05:57
In reply to Re: OTC SSNRI » djmmm, posted by Phillipa on January 18, 2006, at 22:00:18
> Ahhhh pheusophed is in it.
Not in Chlor-Trimeton, it's just Chlorpheniramine Maleate - an antihistamine, it contains no decongestants like pseudofed.
Posted by ed_uk on January 19, 2006, at 13:14:36
In reply to OTC SSNRI, posted by zeugma on January 18, 2006, at 19:06:29
Hi Z
Very interesting Z. Thanks for posting.
Chlorpheniramine is the most widely used 'first generation' antihistamine in the UK. The brand name is Piriton but it's also available as a generic. We sell quite a lot of it OTC. It's pretty cheap.
Ed
Posted by Phillipa on January 19, 2006, at 17:49:26
In reply to Re: OTC SSNRI » Phillipa, posted by Glydin on January 19, 2006, at 13:05:57
Thanks for the correction. Fondly, Phillipa
Posted by zeugma on January 19, 2006, at 19:42:20
In reply to Piriton » zeugma, posted by ed_uk on January 19, 2006, at 13:14:36
I've read reports here and there on this board of people getting an antidepressant effect from antihistamines.
I do know that since my pdoc doesn't want me taking Afrin, I'll ask him about antihistamines. The problem with chlorophrenamine (sp.) is that it looks very sedating.
-z
Posted by yxibow on January 20, 2006, at 1:10:29
In reply to Re: Piriton » ed_uk, posted by zeugma on January 19, 2006, at 19:42:20
> I do know that since my pdoc doesn't want me taking Afrin, I'll ask him about antihistamines. The problem with chlorophrenamine (sp.) is that it looks very sedating.Its a daytime antihistamine at 4mg (some extended release have more), and not the best of ones for allergies (Claritin / generic loratadine is cleaner and better for that purpose). I've never experienced any sedation. On the other hand Benadryl is an unclean sledgehammer for nighttime purposes.
Posted by zeugma on January 20, 2006, at 4:48:16
In reply to Re: Piriton » zeugma, posted by yxibow on January 20, 2006, at 1:10:29
Posted by ed_uk on January 20, 2006, at 13:32:05
In reply to Re: Piriton » ed_uk, posted by zeugma on January 19, 2006, at 19:42:20
Hi Z,
Chlorpheniramine is claimed to be less sedating than diphenhydramine (Benadryl) and promethazine (Phenergan).
The usual dose of chlorpheniramine is 4mg every 4-6 hours.
Ed
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.