Pheniramine dependence in obsessive-compulsive disorder: A case report.

BACKGROUND: Pheniramine abuse is reported not only in patients with psychiatric disorders but also in the general population. CASE REPORT: We report a case of pheniramine dependence in a patient with obsessive-compulsive disorder. The patient took about 250 mg orally daily and injected about 90 mg every week from the last six months. It reduced his anxiety, was cheaper than his other psychiatric medications, and free of stigma. He had lethargy, headache, uneasiness, anxiety, and poor sleep as withdrawal symptoms. RESULTS: This case highlights the vulnerability of those with psychiatric disorders towards pheniramine abuse. Hence, this report advocates the strict evaluation of over-the-counter drugs for patients with pre-existing psychiatric disorders.

Pheniramine maleate: an apparently safe drug causing bullous fixed drug eruption.

Fixed drug eruption is a delayed type hypersensitivity reaction to a drug seen most frequently with antibiotics such as tetracyclines, sulfonamides, and NSAIDs such as naproxen and ibuprofen. Although H1-antihistamines rarely elicit cutaneous adverse effects, there have been a few reports in the literature implicating them in causing fixed drug eruption, particularly the piperazine derivatives (hydroxyzine, cetirizine, levocetirizine), and loratadine. However, cutaneous drug reactions with the alkylamine derivatives like pheniramine maleate are extremely uncommon and fixed drug eruptions have not been reported with any of the alkylamine antihistamines to date. We herein report a case of multifocal bullous fixed drug eruption following ingestion of pheniramine maleate.

Bilateral simultaneous acute angle closure attack triggered by an over-the-counter flu medication.

Most of the rare bilateral acute angle closure (AAC) cases are precipitated by systemic factors, such as drug intake, snake bite or general anaesthesia. We present a case of simultaneous bilateral AAC in a middle-aged male, precipitated by the use of medication for flu, containing an alpha-1 adrenergic receptor agonist and an anticholinergic agent. In our case, axial length was shorter, anterior chamber depth was narrower, and the lens was thicker than normal, including the patient within the risk group for AAC. In this circumstance, drugs acted as triggers. Case description and evolution following treatment are completed with the discussion of mechanisms involved in triggering bilateral AAC in predisposed patients, as emerging from literature. This case report brings up the risk of bilateral AAC in patients at risk, of which ophthalmologists, physicians of other specialties and patients should be aware of.

Hazards of antihistamine dependence in psychiatric patients: a case report.

Excessive use of over-the-counter (OTC) medications has been a growing public health problem. We present the case of a patient with avoidant personality disorder, social phobia, and dull normal intelligence, with dependence to pheniramine maleate. His anxiety symptoms, initially unresponsive to conventional treatment, reduced only after stopping pheniramine during inpatient care. This case emphasizes the need for awareness and regular monitoring of the use of OTC medications in vulnerable patient populations.

[Fixed pigmented erythema antihistamine H1: about 2 cases and review of the literature]. / Érythème pigmenté fixe aux antihistaminiques H1 : à propos de 2 cas et revue de la littérature.

We describe two cases of fixed drug eruptions induced by pheniramine (1(st) case) and loratadine (2(nd) case).

A case of pheniramine dependence.

Abuse and addiction of histaminergic agonists and antagonists were investigated. The withdrawal signs may become after using drugs such as L-histidine, histamine-N-methyl, promethazine, pheniramine, astemizole, etc. Some medicines which include these active metabolites could lead to dependence cause different side effects. This case suggests that pheniramine abuse also could to dependence. We should pay attention to trend of pheniramine and other histaminergic drugs dependence and need to regulate the market by law more severely.

Case report: unilateral mydriasis from topical Opcon-A and soft contact lens.

The use of topical ocular antihistamine/decongestant combinations to treat symptoms associated with allergic conjunctivitis is widespread, effective, and generally without adverse effects. Recently, these medications have become available without a prescription, possibly leading patients to the erroneous assumption that they are void of side effects. Likewise, patients may use these drugs for many ocular therapies for which they are unintended, possibly resulting in ocular complications. One significant adverse effect of these antihistamine/decongestant combinations when used inappropriately is pupillary dilation with associated blurry vision. Continued emphasis of the possible deleterious side effects by the clinician is recommended to circumvent these problems.

Treatment of chronic idiopathic urticaria with topical preparations: controlled study of oxatomide gel versus dechlorpheniramine cream.

A controlled and completely randomized study was carried out with the aim of assessing the efficacy and safety of oxatomide gel in comparison with another preparation for topical use, dechlorpheniramine. Twenty-seven patients (sixteen F, eleven M) aged between 21 and 72 years (mean age 39) suffering from chronic idiopathic urticaria were treated for 15 days with oxatomide gel at 5% or dechlorpheniramine cream at 1%; 15 days of follow-up without therapy were then observed. Both the treatments allowed significant control of cutaneous symptoms. In particular, in the group treated with oxatomide there was a more marked reduction in itching and in the number of weals (p less than 0.01 between times), and in the dechlorpheniramine group in the severity of erythema (p less than 0.01 between times). During the follow-up period, a distinct flare-up of symptoms was observed only in the dechlorpheniramine group. Acceptability and safety, both clinical and biological, were good for both products.