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Does treatment with antidepressants, antipsychotics, or benzodiazepines hamper allergy skin testing?

BACKGROUND: Treatment with commonly used drugs such as antidepressants (ADs), antipsychotics (APs), and benzodiazepines (BDs) may hamper the use of allergy skin testing due to possible antihistaminic effects. OBJECTIVE: To examine the antihistaminic effect of AD, AP, and BD as measured by the abilit...

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Autores principales: Kjaer, Henrik Fomsgaard, Mortz, Charlotte Gotthard, Bindslev‐Jensen, Carsten
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8420966/
https://www.ncbi.nlm.nih.gov/pubmed/34504681
http://dx.doi.org/10.1002/clt2.12060
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author Kjaer, Henrik Fomsgaard
Mortz, Charlotte Gotthard
Bindslev‐Jensen, Carsten
author_facet Kjaer, Henrik Fomsgaard
Mortz, Charlotte Gotthard
Bindslev‐Jensen, Carsten
author_sort Kjaer, Henrik Fomsgaard
collection PubMed
description BACKGROUND: Treatment with commonly used drugs such as antidepressants (ADs), antipsychotics (APs), and benzodiazepines (BDs) may hamper the use of allergy skin testing due to possible antihistaminic effects. OBJECTIVE: To examine the antihistaminic effect of AD, AP, and BD as measured by the ability of these drugs to suppress the normal wheal reaction caused by skin prick test (SPT). METHODS: Skin prick test was performed in patients receiving treatment with AD, AP, and/or BD. Double SPT was performed with histamine solutions of 10, 30, and 100 mg/ml and mean wheal diameter calculated. RESULTS: A total of 313 patients were included. 236 (75%) patients were treated with one of the examined drugs and 77 (25%) patients with more than one of these drugs. Drugs most frequently used was sertraline (n = 65), citalopram (n = 63), mirtazapine (n = 36), venlafaxine (n = 33), and quetiapine (n = 32). Treatment with mirtazapine and/or quetiapine was associated with negative SPTs in 30/36 (83%) and 22/32 (69%), and the antihistaminic effect of these drugs was dose‐dependent. For patients treated with selective serotonin reuptake inhibitors (SSRIs), tricyclic antidepressants (TCAs), serotonin norepinephrine reuptake inhibitors (SNRIs), or BD alone, almost all SPTs were positive (94%, 95%, 100%, and 100%, respectively). Negative SPTs in patients treated with SSRI, TCA, SNRI, or BD and ≥1 other of the examined drugs were associated with simultaneous treatment with mirtazapine or quetiapine in 39/44 (89%) patients. CONCLUSION: Skin testing has little meaning in patients treated with mirtazapine or quetiapine. Treatment with SSRI, SNRI, and BD does not seem to affect the results of SPTs, whereas skin tests in patients treated with TCA should be interpreted with caution.
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spelling pubmed-84209662021-09-08 Does treatment with antidepressants, antipsychotics, or benzodiazepines hamper allergy skin testing? Kjaer, Henrik Fomsgaard Mortz, Charlotte Gotthard Bindslev‐Jensen, Carsten Clin Transl Allergy Research BACKGROUND: Treatment with commonly used drugs such as antidepressants (ADs), antipsychotics (APs), and benzodiazepines (BDs) may hamper the use of allergy skin testing due to possible antihistaminic effects. OBJECTIVE: To examine the antihistaminic effect of AD, AP, and BD as measured by the ability of these drugs to suppress the normal wheal reaction caused by skin prick test (SPT). METHODS: Skin prick test was performed in patients receiving treatment with AD, AP, and/or BD. Double SPT was performed with histamine solutions of 10, 30, and 100 mg/ml and mean wheal diameter calculated. RESULTS: A total of 313 patients were included. 236 (75%) patients were treated with one of the examined drugs and 77 (25%) patients with more than one of these drugs. Drugs most frequently used was sertraline (n = 65), citalopram (n = 63), mirtazapine (n = 36), venlafaxine (n = 33), and quetiapine (n = 32). Treatment with mirtazapine and/or quetiapine was associated with negative SPTs in 30/36 (83%) and 22/32 (69%), and the antihistaminic effect of these drugs was dose‐dependent. For patients treated with selective serotonin reuptake inhibitors (SSRIs), tricyclic antidepressants (TCAs), serotonin norepinephrine reuptake inhibitors (SNRIs), or BD alone, almost all SPTs were positive (94%, 95%, 100%, and 100%, respectively). Negative SPTs in patients treated with SSRI, TCA, SNRI, or BD and ≥1 other of the examined drugs were associated with simultaneous treatment with mirtazapine or quetiapine in 39/44 (89%) patients. CONCLUSION: Skin testing has little meaning in patients treated with mirtazapine or quetiapine. Treatment with SSRI, SNRI, and BD does not seem to affect the results of SPTs, whereas skin tests in patients treated with TCA should be interpreted with caution. John Wiley and Sons Inc. 2021-09-06 /pmc/articles/PMC8420966/ /pubmed/34504681 http://dx.doi.org/10.1002/clt2.12060 Text en © 2021 The Authors. Clinical and Translational Allergy published by John Wiley & Sons Ltd on behalf of European Academy of Allergy and Clinical Immunology. https://creativecommons.org/licenses/by/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research
Kjaer, Henrik Fomsgaard
Mortz, Charlotte Gotthard
Bindslev‐Jensen, Carsten
Does treatment with antidepressants, antipsychotics, or benzodiazepines hamper allergy skin testing?
title Does treatment with antidepressants, antipsychotics, or benzodiazepines hamper allergy skin testing?
title_full Does treatment with antidepressants, antipsychotics, or benzodiazepines hamper allergy skin testing?
title_fullStr Does treatment with antidepressants, antipsychotics, or benzodiazepines hamper allergy skin testing?
title_full_unstemmed Does treatment with antidepressants, antipsychotics, or benzodiazepines hamper allergy skin testing?
title_short Does treatment with antidepressants, antipsychotics, or benzodiazepines hamper allergy skin testing?
title_sort does treatment with antidepressants, antipsychotics, or benzodiazepines hamper allergy skin testing?
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8420966/
https://www.ncbi.nlm.nih.gov/pubmed/34504681
http://dx.doi.org/10.1002/clt2.12060
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