Use of H₁-Antihistamines in Children Is Not Based on Good Evidence

First-generation antihistamines are marketed for a number of allergic and nonallergic indications in children. Investigators from Belgium reviewed the literature from four major publication databases to assess evidence supporting use of three of these antihistamines — alimemazine, cyproheptadine, and dimethindene maleate — and to identify potential adverse drug reactions.

For alimemazine, licensed in some European countries for various indications in children, randomized, controlled trials examining efficacy for sleep disorders showed conflicting results. No randomized, placebo-controlled trials examined the use of alimemazine for pruritus. One randomized, controlled trial in children found benefit for reducing post-fundoplication emesis. Fo…