Diphenhydramine as an analgesic adjuvant in refractory cancer pain Journal Article


Authors: Santiago-Palma, J.; Fischberg, D.; Kornick, C.; Khojainova, N.; Gonzales, G.
Article Title: Diphenhydramine as an analgesic adjuvant in refractory cancer pain
Abstract: Clinical and animal data suggest that antihistamines may have efficacy in the management of pain. While many mechanisms of action have been proposed for the analgesic action of antihistamines, the exact mechanism is unknown. Controlled clinical trials in different pain models have demonstrated that antihistamines have direct and adjuvant analgesic activity. We report three patients with advanced cancer pain refractory to adjuvants and oral, intravenous, and epidural opioids, who achieved sustained pain relief after the repeated administration of diphenhydramine. Diphenhydramine may be useful in the treatment of neuropathic and nociceptive pain that has failed to respond to treatment with opioids and adjuvant analgesics. We suggest a starting dose of 25 mg of oral or parenteral diphenhydramine every 6 to 8 hours, with titration to effect. Copyright © 2001 .
Keywords: adult; child; school child; aged; middle aged; case report; drug efficacy; nuclear magnetic resonance imaging; positron emission tomography; technetium 99m; neoplasms; metastasis; computer assisted tomography; pain; lung non small cell cancer; methylphenidate; opiate; delirium; sedation; dexamethasone; steroid; cancer pain; herpes zoster; confusion; thorax pain; neuroblastoma; anxiety; methadone; morphine; lidocaine; alprazolam; bupivacaine; analgesia; patient controlled analgesia; neuropathic pain; citalopram; thorax wall; bone scintiscanning; analgesic agent; pain, intractable; antihistaminic agent; fentanyl; gabapentin; diphenhydramine; clonidine; amitriptyline; histamine h1 antagonists; antihistamine; cancer; humans; human; male; female; article; adjuvant analgesic; nociceptive pain; upper respiratory tract obstruction
Journal Title: Journal of Pain and Symptom Management
Volume: 22
Issue: 2
ISSN: 0885-3924
Publisher: Elsevier Inc.  
Date Published: 2001-08-01
Start Page: 699
End Page: 703
Language: English
DOI: 10.1016/s0885-3924(01)00311-6
PUBMED: 11495716
PROVIDER: scopus
DOI/URL:
Notes: Export Date: 21 May 2015 -- Source: Scopus
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  1. Natalie Moryl
    64 Moryl
  2. Craig A Kornick
    12 Kornick