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Antihistamine-related deaths in England: Are the high safety profiles of antihistamines leading to their unsafe use?

Research output: Contribution to journalArticlepeer-review

Original languageEnglish
Pages (from-to)3978-3987
Number of pages10
JournalBritish Journal of Clinical Pharmacology
Issue number10
PublishedOct 2021

Bibliographical note

Funding Information: The authors would like to thank Hugh Claridge and Christine Goodair for their ongoing advice and support of NPSAD. No funding source. Publisher Copyright: © 2021 The Authors. British Journal of Clinical Pharmacology published by John Wiley & Sons Ltd on behalf of British Pharmacological Society. Copyright: Copyright 2021 Elsevier B.V., All rights reserved.


  • Manuscript Final_BJCP_Revised_CLEAN

    Manuscript_Final_BJCP_Revised_CLEAN.docx, 127 KB, application/vnd.openxmlformats-officedocument.wordprocessingml.document

    Uploaded date:29 Jun 2021

    Version:Accepted author manuscript

    Licence:CC BY

King's Authors


Aims: Antihistamines are routinely taken to control allergic reactions or sedation to induce sleep. There are, however, growing concerns regarding sedating antihistamine misuse. This research aims to evaluate deaths related to antihistamines in England occurring during 2000–2019. Methods: Cases reported to the National Programme on Substance Abuse Deaths from England occurring in 2000–2019 with antihistamine detections at postmortem were extracted for analysis. Results: In total, 1666 antihistamine postmortem detections were identified from 1537 cases. Sedating antihistamines available for purchase under pharmacist supervision but without need for a prescription (pharmacy-only medications) were present in a significant majority of cases (85.2%, P <.01). Despite an increasing trend for antihistamine-related deaths over time, the proportion of deaths where an antihistamine was implicated declined over the same period. Specific concerns with regards to the misuse of these pharmacy-only sedating antihistamines are raised with regards to the significant proportion of cases that were concluded as suicide (20.9%, P <.01), and the high prevalence of their use in combination with other central nervous system depressants (94.8% of cases). Conclusion: This is the first report in over 40 years regarding antihistamine-related mortality from England. The rising trend in sedating antihistamine-related deaths may be contributed to by their increasing availability and the perceived negligible dangers associated with antihistamines, both from the general public and learned professionals. Awareness of the dangerous sedative properties that some antihistamines possess is, however, heightened in individuals deliberately seeking these effects. Urgent review of sedating antihistamines currently assigned under the pharmacy-only classification is needed to achieve antihistamine harm reduction.

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