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Australian Prescriber Apr 2021
Review
PubMed: 33911336
DOI: 10.18773/austprescr.2021.009 -
Prescrire International Nov 2015
Topics: Dimenhydrinate; Diphenhydramine; France; Histamine H1 Antagonists; Humans; Substance-Related Disorders
PubMed: 26688907
DOI: No ID Found -
Neuroscience and Biobehavioral Reviews Jan 2002The over-the-counter anti-emetic dimenhydrinate (DMH) (Gravol or Dramamine) has been reported to be abused for non-medicinal purposes. Street drug users abuse DMH for... (Review)
Review
The over-the-counter anti-emetic dimenhydrinate (DMH) (Gravol or Dramamine) has been reported to be abused for non-medicinal purposes. Street drug users abuse DMH for the acute effects of euphoric sensations and hallucinations, while psychiatric patients abuse DMH for its anxiolytic or anti-cholinergic effects. DMH is an H(1) histamine receptor antagonist, but it interacts either directly or indirectly with other neurotransimitter systems, including those using acetylcholine, serotonin, norepinephrine, dopamine, opioids or adenosine. Animal behavioural studies, such as self-administration, conditioned place preference, drug discrimination, and modulation of operant responding, show that anti-histamines have abuse potential. Further support comes from reports of acute and chronic abuse of DMH by humans. Collectively, results confirm the abuse liability of DMH.
Topics: Animals; Behavior; Brain Chemistry; Dimenhydrinate; Histamine H1 Antagonists; Humans; Substance-Related Disorders
PubMed: 11835984
DOI: 10.1016/s0149-7634(01)00038-0 -
Pediatrics Apr 2020Several antiemetics have been used in children with acute gastroenteritis. However, there is still controversy over their use. (Meta-Analysis)
Meta-Analysis
CONTEXT
Several antiemetics have been used in children with acute gastroenteritis. However, there is still controversy over their use.
OBJECTIVE
To determine the effectiveness and safety of antiemetics for controlling vomiting in children with acute gastroenteritis.
DATA SOURCES
Medline, Embase, Cochrane Central Register of Controlled Trials, Cumulative Index to Nursing and Allied Health Literature, Latin America and the Caribbean Literature on Health Sciences, and gray literature, until December 2018.
STUDY SELECTION
We selected randomized clinical trials comparing metoclopramide, ondansetron, domperidone, dexamethasone, dimenhydrinate, and granisetron.
DATA EXTRACTION
Two reviewers independently screened abstracts and full texts, extracted the data, and assessed the risk of bias. We performed pairwise and network meta-analysis using the random-effects model.
RESULTS
Twenty-four studies were included (3482 children). Ondansetron revealed the largest effect in comparison to placebo for cessation of vomiting (odds ratio = 0.28 [95% credible interval = 0.16 to 0.46]; quality of evidence: high) and for hospitalization (odds ratio = 2.93 [95% credible interval = 1.69 to 6.18]; quality of evidence: moderate). Ondansetron was the only intervention that reduced the need for intravenous rehydration and the number of vomiting episodes. When considering side effects, dimenhydrinate was the only intervention that was worse than placebo.
LIMITATIONS
Most treatment comparisons had low- or very low-quality evidence, because of risk of biases and imprecise estimates.
CONCLUSIONS
Ondansetron is the only intervention that revealed an effect on the cessation of vomiting, on preventing hospitalizations, and in reducing the need for intravenous rehydration. Ondansetron was also considered a safe intervention.
Topics: Acute Disease; Antiemetics; Child; Child, Preschool; Dexamethasone; Diarrhea; Dimenhydrinate; Domperidone; Fluid Therapy; Gastroenteritis; Granisetron; Hospitalization; Humans; Infant; Metoclopramide; Network Meta-Analysis; Ondansetron; Randomized Controlled Trials as Topic; Regression Analysis; Vomiting
PubMed: 32132152
DOI: 10.1542/peds.2019-3260 -
Journal of Clinical Psychopharmacology Feb 2015
Topics: Adult; Chronic Disease; Dimenhydrinate; Female; Humans; Psychotic Disorders; Substance-Related Disorders
PubMed: 25392935
DOI: 10.1097/JCP.0000000000000238 -
Canadian Journal of Psychiatry. Revue... Mar 1993Dimenhydrinate may be a relatively common yet unrecognized substance of abuse among adolescents. Abuse of this drug may present as a psychiatric syndrome, particularly...
Dimenhydrinate may be a relatively common yet unrecognized substance of abuse among adolescents. Abuse of this drug may present as a psychiatric syndrome, particularly depression. Three cases are presented which illustrate this relationship. A review of the literature is presented and suggestions are made for identifying adolescents who abuse dimenhydrinate.
Topics: Adolescent; Depressive Disorder; Dimenhydrinate; Disorders of Excessive Somnolence; Dose-Response Relationship, Drug; Electroencephalography; Epilepsy, Tonic-Clonic; Euphoria; Female; Humans; Male; Motivation; Social Environment; Social Identification; Substance-Related Disorders
PubMed: 8467436
DOI: 10.1177/070674379303800208 -
CMAJ : Canadian Medical Association... May 1990
Topics: Adult; Dimenhydrinate; Female; Humans; Substance Withdrawal Syndrome; Substance-Related Disorders
PubMed: 2328468
DOI: No ID Found -
Canadian Family Physician Medecin de... Apr 2011Dimenhydrinate is an over-the-counter drug that is commonly used for the treatment of nausea and vomiting. Many of my adult patients use it, but is it safe and useful in...
QUESTION
Dimenhydrinate is an over-the-counter drug that is commonly used for the treatment of nausea and vomiting. Many of my adult patients use it, but is it safe and useful in the pediatric population?
ANSWER
Dimenhydrinate appears to be safe for use in the pediatric population. While little literature has been published about adverse effects of this medication, family physicians need to identify the cause of the vomiting before considering if the drug will be effective and need to ensure that patients safely use the medication and avoid potential interaction of the drug with other products.
Topics: Adolescent; Antiemetics; Child; Child, Preschool; Dimenhydrinate; Drug Interactions; Gastroenteritis; Humans; Infant; Motion Sickness; Nonprescription Drugs; Vomiting
PubMed: 21490354
DOI: No ID Found -
Journal of Psychiatric Research Apr 2021Dimenhydrinate (DMH) is an antihistamine used to treat nausea and vomiting. Although widely available in pharmacies as an over the counter medication, there have been... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Dimenhydrinate (DMH) is an antihistamine used to treat nausea and vomiting. Although widely available in pharmacies as an over the counter medication, there have been reports of potential DMH tolerance and dependence and a possible euphoric potential accompanying heavy use (>100 mg/day). Despite the potential for misuse, there is a gap in the literature concerning patterns, characteristics, and potential mechanisms of DMH misuse.
AIMS
This review aimed to synthesize evidence on the pharmacology, clinical effects, and management of DMH misuse and dependence to inform clinical decision making and relevant drug policy.
METHODS
We conducted a systematic review in accordance with the PRISMA guidelines and using Cochrane collaboration methods. We searched seven databases from their inception through July 2019. To be included in the review, studies needed to measure or focus on one or more dimensions of morbidity or mortality related to the misuse of DMH. Quantitative, qualitative and mixed-method studies were included in order to capture the breadth of possible studies. Studies were excluded if they did not fit into the conceptual framework of the study of if they focused primarily on the misuse of other substances. A narrative synthesis of study findings was pursued given the limited capacity for a quantitative meta-analysis.
FINDINGS
We identified 24 studies, which described a range of neuropsychiatric sequelae related to DMH consumption, including seizures, psychosis, depression, intoxication (resembling anticholinergic syndrome) and withdrawal. The sedative and euphoric properties, readily available nature, and low cost of DMH appear to facilitate DMH dependence, which were more commonly reported among individuals who had concurrent psychiatric disorders, displaying symptoms such as low motivation, poor concentration, and delirium. The overall quality of studies identified by this review was low-largely because the majority of studies were case reports or review articles, with few intervention or cohort studies.
CONCLUSIONS
There is some evidence to suggest the existence of DMH-related syndromes involving intoxication, withdrawal, and dependence, more commonly among long-term, heavy DMH consumers. However, higher quality studies are needed to confirm preliminary findings that there may be a biological basis for such syndromes.
Topics: Dimenhydrinate; Humans; Psychotic Disorders
PubMed: 33153760
DOI: 10.1016/j.jpsychires.2020.10.032 -
The Medical Letter on Drugs and... Oct 2019
Review
Topics: Animals; Antimalarials; Diarrhea; Humans; Insect Bites and Stings; Malaria; Travel; Travel-Related Illness
PubMed: 31599872
DOI: No ID Found